Mozes and Helen Stern Counseling Center
Please fill out the following fields to schedule an Intake Appointment with a Upward Community social worker. Once we receive the request someone will get back to you as soon as possible. In addition, please fill out the COVID-19 Liability Form here for in-person appointments.
To prepare for an Intake Appointment please download all the forms and send them back to us at firstname.lastname@example.org.
- Informed consent for in-person services during Covid-19
- Client Grievance
- Consent to Services
- Financial Agreement
- Insurance Release
- Upward Community Card on File
- Parent Assessment
- Primary Care Physician Release
- Release of Mental Health
- Sliding Scale