• Home
  • Mission and Vision Jesse Gainsbrugh, LPC, BCPCC
  • Services and Fees Appointments Client Forms
  • Location
  • Scripture FAQs Blog Contact Hotlines and Links

  • Home/
  • About Us/
    • Mission and Vision
    • Jesse Gainsbrugh, LPC, BCPCC
  • New Clients/
    • Services and Fees
    • Appointments
    • Client Forms
  • Location/
  • Resources/
    • Scripture
    • FAQs
    • Blog
    • Contact
    • Hotlines and Links

Client Forms

  • Home/
  • About Us/
    • Mission and Vision
    • Jesse Gainsbrugh, LPC, BCPCC
  • New Clients/
    • Services and Fees
    • Appointments
    • Client Forms
  • Location/
  • Resources/
    • Scripture
    • FAQs
    • Blog
    • Contact
    • Hotlines and Links

Please print and complete the applicable form(s) before your first office visit:

 

Required Forms

New Client Agreement


Financial Agreement

Additional Information

Notice of Privacy Practices

Optional Paperwork

  • Depression Inventory (Adults)

  • Depression Inventory (Adolescents)

  • Anxiety Inventory

  • Mood Disorder Questionnaire

  • Social Anxiety Questionnaire

  • Eating Attitudes Test

  • Attention Issues Test for Adults

  • Alcohol Issues Brief Test

  • Drug Issues Inventory for Adolescents

  • Drug Issues Inventory for Adults

  • Well-Being Inventory

 

  • Home/
  • About Us/
    • Mission and Vision
    • Jesse Gainsbrugh, LPC, BCPCC
  • New Clients/
    • Services and Fees
    • Appointments
    • Client Forms
  • Location/
  • Resources/
    • Scripture
    • FAQs
    • Blog
    • Contact
    • Hotlines and Links

A Christian Place Counseling is group of mental health professionals helping others to explore and develop changes needed to live an inspired and healthy life.   We work together to provide a professional Christian counseling ministry to our community. Please call us and inquire about our services for you and your loved ones. 

🗓️ Schedule a Virtual Visit

Call/Text: 404.590.8117

Georgia Tele-Counseling

Get Updates from Us!

Thank you!

Copyright A Christian Place Counseling LLC 2014