HEALTHY OPTIONS COUNSELING SERVICES LLC
Mental Health, Neurotherapy, and Nutritional Therapy Services
 
 
    Call Us :1-888 509 9040
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Jose F. Vasquez, Psy.D., Ph.D., LPC, LMHC, CPCS

Dr. Sara Franco-Vasquez, Psy.D., NTP

3540 Wheeler Rd. Suite 619
Augusta, GA 30909
Ph (888) 509 9040
FAX # is (360)350-3569

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Client Intake Forms

Client Intake Forms

If you're a new client, please download and complete the following forms, and bring them to your first therapy session.

  • Client Intake Form
  • Client Satisfaction Form

If you would like me to coordinate care with another provider (for example, your psychiatrist, primary care physician, etc, complete this form to authorize release of psychotherapy information:

  • Authorization to Disclose Information Form

Note: To download Adobe Acrobat Reader for free, click here.

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