Client Forms

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Please download applicable forms and bring them to your first appointment

Forms

Client Intake

Professional Disclosure Statement

HIPAA Release Form (PDF)

HIPAA (DOC)

Professional Disclosure Statements

Monica’s Professional Disclosure Statement

Erika’s Professional Disclosure Statement

Enriching Lives, Strengthening Relationships, Empowering Families

Spicer Counseling Services, LLPC

Phone: 989.292.3432

Fax: 517.668.2626

monicaspicerlpc@gmail.com

Your Path to Wellness

122 North Bridge Street Dewitt, MI 48820

Serving the communities of St. Johns, 48879; DeWitt, 48820; Fowler, 48835; Ovid, 48866; Elsie, 48831; Bannister, 48807; Carson City, 48811; Corunna, 48817; Eureka, 48833; Hubbardston, 48845; Ionia, 48846; Ithaca, 48847; Laingsburg, 48848; Maple Rapids, 48853; Middleton, 48856; Muir, 48860; North Star, 48862; Owosso, 48867; Palo, 48870; Perrinton, 48871; Pewamo, 48873; Pompeii, 48874; St. Louis, 48880; and Westphalia, 48894.