SCC Suburban Crossroads Counseling
  • Home
  • Mission
  • Our Therapists
    • Donna Kilmore
    • Susan Ashtianie
    • Tyler Howard
    • Job Opportunities
  • Locations
    • Catonsville
    • Towson
  • Forms
  • Contact Us
  • Insurance & Payment
  • Home
  • Mission
  • Our Therapists
    • Donna Kilmore
    • Susan Ashtianie
    • Tyler Howard
    • Job Opportunities
  • Locations
    • Catonsville
    • Towson
  • Forms
  • Contact Us
  • Insurance & Payment

Forms

Please review and sign these forms and bring them with you to your first appointment.
Please note: To complete the forms online, choose to print the file, then "Save as a PDF" to save the entered information. You will then be able to save the file to your computer.

New Client

Notice of Privacy Practices

Personal History Questionnaire

Release of Information

Card Authorization (please write the 3-digit security code next to the card number)

Suburban Crossroads Counseling
www.baltimorecounselingservices.org
Office locations in Catonsville and Towson
Serving all of Maryland through telehealth
Suburban Crossroads Counseling (SCC) does not discriminate on the basis of race, ethnic background, religion, gender,
​gender expression, age, national origin, disability, marital status, sexual orientation, or military status.

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