Forms and Documents

Intake Forms and Your Account Information

If you have a pressing matter, please contact us.
scheduling@acuitycounseling.net or call 206-910-9476

NEW CLIENT FORM (ADULT)

NEW CLIENT FORM (ADULT)

18+ YEARS OLD

NEW CLIENT FORM (MINOR)

NEW CLIENT FORM (MINOR)

5-17 YEARS OLD

RELEASE OF INFORMATION FORM

RELEASE OF INFORMATION FORM

Form (ROI)

CREDIT CARD INFORMATION

CREDIT CARD INFORMATION

Update Financial Agreement

INSURANCE CARD INFORMATION

INSURANCE CARD INFORMATION

Update your Insurance

Acuity Counseling Locations

Seattle

Bellevue

Bothell/Woodinville

BELLEVUE, WA
Cascade Place II
12729 Northup Way, Suite 6
Bellevue WA 98005
(206) 910-9476

SEATTLE, WA
Plaza 600 Building
600 Stewart St, Suite 1228
Seattle WA 98101
(206) 910-9476

BOTHELL/WOODINVILLE
Falcon View
12900 NE 180th St, Suite 160
Bothell, WA 98011
(206) 910-9476

Schedule your online session now

 
Putting client and staff safety first, all sessions are being conducted via secure video calls. Schedule your online session now. 
 
Now covered by your health insurance.
We're here for you!
Learn More About Online Counseling here >

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