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  • Jim Ciraky | Advent Help

    • About
      • How Can Therapy Help You?
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      • Individual Counseling
      • Couples Counseling
      • Family Counseling
      • Adolescent / Teen Counseling
      • Children’s Counseling
      • Critical Incident Stress Debriefing
      • National & International Coaching
      • Christian Counseling
      • Telehealth Counseling
      • Anxiety
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      • Woodstock, GA
      • Smyrna, GA
      • Marietta, GA
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    Client Forms

    Adult

    If you are an adult client, please download, complete, and bring to your first appointment the following Form, which will save you about 20 minutes at the office:

    Click Here to download and complete the adult form

    Also, read the HIPAA and Therapy Agreement/Policies/Consent Forms. These are available for download if you wish to store or print them for yourself. You will be asked to initial and sign a form in my office that you agree with the information in each of these forms.

    Child/Adolescent

    If you are bringing a child/adolescent client for counseling, please download, complete, and bring to your first appointment the following Forms:

    Click Here to download and complete the Child/Adolescent Form

    Of course, I will answer any questions you have about the forms. I look forward to working with you soon.

    Jim Ciraky PhD., LPC


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    Administrative Office:

    2210 Holly Springs Parkway # 663
    Holly Springs, GA 30142

    Clinical Offices:

    Woodstock, Smyrna, Marietta

    404-293-5654
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    404-293-5654

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    For the health, safety, and well-being of our clients and providers, we have added virtual appointments to our in-person sessions, so you have the option of doing either. All virtual appointments are available through HIPAA compliant, secure video or on the phone. We look forward to continuing to provide excellent care and service to our clients during this challenging time.

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