Lyon Counseling Patient Intake Form

Step 1:

Please download the Lyon Counseling Intake Form to complete and upload in the following step.

Step 2:

Please provide your name.

Step 3:

Please upload your completed intake form.

Step 4:

Please make sure you have read and understood all terms, conditions and agreements as laid out in the Lyon Counseling Patient Intake Form and acknowledge below:

I have read and accept the Fees & Charges

I have read and accept the Informed Consent

I have read and accept the Privacy Practices

Sign Here