The Center for
Family Counseling
and Education

If you would like to begin counseling with CFCE, please do the following:

Please download to your computer and fill out completely and accurately all sections of the PDF fillable forms of the CFCE adult or child client pre-intake information form, one for each person you wish to receive counseling services (links to these documents below). Please do not leave any sections of this form blank. If requested information does not apply to you, please state "Does not apply" in that section. Incomplete CFCE adult or child client pre-intake information forms will be returned to have missing information provided. When you have completed this/these form(s), save it/them with a file name such as "CFCE adult client pre-intake information form" followed by the name or initials of the person for whom each form is being submitted. Then go to the "Contact Us" page of this website, fill in the information requested (name, phone number, email address, message), click on the "Choose File" button under "Pre-Intake Information Form:" and select the file/files from wherever you have saved it/them on your computer to attach that/those forms to your email, and click on the "Submit" button to transmit your email and forms.

Sign the CFCE informed consent form, one for each person you wish to receive counseling services (link to this document below). You may sign electronically by typing in your complete name. A parent or legal guardian must sign for a minor child (younger than 18 years old) and include the name of the minor child beneath that signature. When you have signed this/these form(s), save it/them with a file name such as "CFCE informed consent form" followed by the name or initials of the person for whom each form is being submitted. Then go to the "Contact Us" page of this website, fill in the information requested (name, phone number, email address, message), click on the "Choose File" button under " Informed Consent Form:" and select the file/files from wherever you have saved it/them on your computer to attach that/those forms to your email, and click on the "Submit" button to transmit your email and forms.

Informed Consent Form Adult Pre-Intake Form Child Pre-Intake Form

The CFCE informed consent form is required with a CFCE client pre-intake information form for all adults and/or children seeking counseling.

We are not able to schedule a first counseling session until the Director of Services has received and been able to review these forms to determine the suitability of our agency to your counseling needs and the fee, if any, that you will be charged for each counseling session. Once that has happened, the Director of Services will forward these forms to one of our counselors with a request to review them and then to contact you as soon as possible to set up your first counseling session with you.

Please note that, due to the volume of undesired sales and solicitation calls received by CFCE, any calls to the CFCE phone (607-656-7828) that have caller ID blocked (appear as "Restricted" or "Unknown") will not be answered.

If you send an incomplete CFCE adult or child client pre-intake information form for each person for whom you wish to begin counseling or fail to include a signed CFCE informed consent form for each person for whom you wish to begin counseling, you will be notified to provide the missing information or missing form(s), and the beginning of your counseling will be delayed until all of the missing information or missing form(s) or both are received.