ACS Admission Forms

Advanced Counseling Services must have the forms titled "Intake Form" and "Informed Consent" completed and returned prior to your appointment.  Forms can be returned via email to therapy@advancedcounselingnj.com.  These forms are pdf for an easy upload.  If you have any trouble completing the forms please let us know via email.  

The form titled "Authorization for Release" is optional.  As disclosed on the form, the purpose is so your therapist is able to communicate with a friend, family member, or funding source.  Per HIPAA and 42 CFR PART II, a therapist or any mental health professional is unable to communicate with anyone other than the patient unless there is written consent (Authorization for Release).  This includes appointment scheduling and confirmation.  Please note these forms were created in 2017 and are subject to change.