Molokai Mental Health

 

 

Confidential Forms

 

Adult (18 or older), fill out the 2 forms below.

• Form #1: Counseling Policies Adult: .pdf or .docx

• Form #2: Patient History Adult: .pdf or .docx

 

Child/Adolescent (Under 18), fill out the 2 forms below.

• Form #1: Counseling Policies Child/Adolescent: .pdf or .docx

• Form #2: Patient History Child/Adolescent: .pdf or .docx

 

 

 

Counseling Forms

Prior to your first visit, kindly fill out the two forms (2 forms per client) and bring them in to your first appointment.

If you are unable to download these forms; please contact us, providing your mailing address and we will mail them to you.