Alase Center For Enrichment
Helping to Heal Hearts, Minds and Souls 



"FORMS" 
INTAKE PACKAGE
In this form you will provide information about yourself and the purpose for the therapy you are seeking. The information you provide, will be discussed when you come in on your first session. Print and complete this form in its entirety. Please have this package completed when you come for your first appointment.
MARRIAGE INTAKE PACKAGE
In this form you will need to provide information about you, and your spouse, and also the purpose for the marriage therapy. The information you provide will be discusssed during your first therapy session. Print and complete this form in its entirety. Please have this package completed when youcome for your first appointment.
CHILD HISTORY 
In this form you will need to provide information about your child and the purpose for their therapy. The information you provide will be discussed during your child's first session. Print and complete this form in its entirety. Please have this package completed when you come for your first appointment. 
If you would like to submit your form online send it in an email as an attachment to triume_3@yahoo.com. It will be kept until your first initial visit.... Thank you