The confidential and secure Client Portal can be accessed by clicking the button below. 

When using the client portal to complete documentation it is recommended you use a computer and not a mobile device.

If you don’t have a portal account yet, please request one during your next office visit or by calling (248)834-3577.

Intake Documentation

The following items are needed for your intake appointment and may be downloaded by clicking on the item below. Documents can be uploaded to the client portal, emailed to contact@lillybrookcs.com, or brought with you to your appointment.  Call 248-834-3577 to confirm which documents you will need to complete.  ALL NECESSARY DOCUMENTS ARE NEEDED AT THE TIME OF INTAKE.

All Clients

      Alternative Communication Form 

      Credit Card Form 

      Informed Consent to Treat

      Primary Care Physician Authorization 

      Program rules

      Recipient Rights 

COVID-19 Forms 

      COVID-19 Safety Measures, Policies, and Procedures and Informed Consent

      

Individual Therapy

      Adult Screening Form

      Child/Adolescent Screening Form

      Readmission Intake Form - To be completed by all clients returning to therapy less than a year last seen. 

             Please also complete an Informed Consent to Treat

Family Therapy

All adult parties participating in therapy most also complete the documents listed under "All Clients" and "COVID-19 Forms."

      Family Information Form  - To be completed by each head of household. 

      Personal Information Form To be completed by every member of the family participating in therapy. 

Marriage/Partner Relational

All parties must also complete the forms listed under "All Clients" and COVID-19 Forms." 

      PR Consent to Treat To be completed by both parties participating in therapy. 

      PR Personal History Information  To be completed by both parties participating in therapy. 

Professional Consultation

      Professional Consultation Consent 

            Please also complete the Alternative Communication Form

Telemedicine/Telehealth

Please also complete all  necessary paperwork pertaining to the service being rendered (i.e. Individual Therapy, Family Therapy, Marriage/Partner Relational, Professional Consultation. 

      Telemedicine Consent 

      Telemedicine Client Instructions 

      

 

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Lillybrook Counseling Services 

3190 Rochester Rd. Suite 105

Troy, MI 48083

(248)834-3577

contact@lillybrookcs.com