(502) 599-4747

  • Home
  • Services
  • Contact Me
  • More
    • Home
    • Services
    • Contact Me

(502) 599-4747

  • Sign In
  • Create Account
  • Bookings
  • My Account

  • Signed in as:

  • filler@godaddy.com

  • Bookings
  • My Account

  • Sign out

Signed in as:

filler@godaddy.com

  • Home
  • Services
  • Contact Me

Account

  • Bookings
  • My Account

  • Sign out

  • Sign In
  • Bookings
  • My Account

Client Contract

Download our client contract forms and return them below before your appointment. 

AUTHORIZATION FOR RELEASE (docx)

Download

Demographic Information (docx)

Download

CLIENT SERVICE AGREEMENT (docx)

Download

Contact Me

Drop us a line!

Attach Client Contract
Attachments (0)

This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.

!

Reboot your brain counseling

(502) 599-4747

Hours

Mon

09:00 am – 05:00 pm

Tue

09:00 am – 05:00 pm

Wed

09:00 am – 05:00 pm

Thu

09:00 am – 05:00 pm

Fri

09:00 am – 05:00 pm

Sat

Closed

Sun

Closed

Copyright © 2024 Reboot your brain counseling  - All Rights Reserved.

This website uses cookies.

We use cookies to analyze website traffic and optimize your website experience. By accepting our use of cookies, your data will be aggregated with all other user data.

Accept