Helping people in central New Mexico find wholeness and healing through professional psychological counseling and education.

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Client Resources & Forms

Everything you need to begin your journey with Samaritan Counseling Center

Below are the forms new clients need to fill out before receiving treatment at Samaritan Counseling Center. The forms are provided in both English and Spanish. Forms for Samaritan Center for Changing Families can be found below.

Please print, complete and bring your forms with you to your first appointment, along with your insurance card, drivers license and payment. If you need to drop the forms off ahead of your session, please secure them in an envelope to insure continued confidentiality.

Samaritan Counseling Center
1101 Medical Arts Avenue, NE
Building 3
Albuquerque, NM 87102

Close-up of psychiatrist hands together holding palm of her patient

New client packets


English-Court Order Paperwork

Children under 18-English

Spanish-Court Order Paperwork


Niños menor de 18 años-Español

Therapist taking notes on her smiling patient on couch in office

Program involvement forms

Samaritan Center for Changing Families Forms
If you plan to participate in Wise Parent Counseling, Mediation and other services provided through the Samaritan Center for Changing Families, you will need to complete the following packet.

Cooperative Parenting Classes

The Samaritan Center for Changing Families offers Cooperative Parenting Classes for divorced or separated parents. Both parents are encouraged to attend Cooperative Parenting Classes as part of your commitment to child-centered parenting.

Authorization for Release of Information

This form, when completed and signed by you, authorizes Samaritan to release or acquire protected information concerning your clinical records from or to the person you designate.