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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 Children and Families are in the next section.
Please print, complete and return forms to:
Samaritan Counseling Center
1101 Medical Arts Avenue, NE
Building 3
Albuquerque, NM 87102
fax: 505-765-1100
Samaritan Center for Changing Families Forms
Click below to open the forms for Wise Parent Counseling, Mediation and Therapy provided through the Samaritan Center for Changing Families.
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.
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