New clients must complete a New Client Intake Form, Credit Card Authorization Form and a Client Insurance Release Form before their first session.

If a client is receiving telehealth counseling (online counseling) and this is the first time receiving this service with our practice, they must also complete a Telehealth Consent Form.

These forms can be printed out and either emailed to alexandrapetrohilos@gmail.com or brought to the first session if the first session is in-person. If you have any questions please call the office at 630-286-2785 or send an email to alexandrapetrohilos@gmail.com.

New Client Intake Form

Click the Link Below to Download Form.

Credit Card Authorization Form

Click the Link Below to Download Form.

Client Insurance Release Form

Click the Link Below to Download Form.

Release of Information Form

Click the Link Below to Download Form.

Telehealth Consent Form

Click the Link Below to Download Form.