Forms

Client Registration Form

Before starting your treatment fill out this form including your history and what you’re struggling with.

Registration Form

Video Therapy Consent Form

To use our video therapy system, Doxy.me, first fill out this consent form

Video Therapy Consent Form

Contract for Services

Before treatment begins, please review our contract for services and complete the form at the bottom

Contract for Services

Consent for Release of Information

To better serve you, we are able to, with your permission, send and receive medical records

Information Release Form

How to get started

  1. Explore our site and see how we can help.
  2. Call and make an appointment – (608) 807-5991
  3. Fill out Registration Form
  4. Sign Service Contract
  1. Explore nuestra pagina web para ver si esta interesado(a) en nuestros servicios
  2. Contactenos para hacer una cita- (608) 807-5991
  3. Llene la hoja de Registro en español y sométala.
  4. Llene la hoja de Contrato por Servicios y sométala.

Your new beginning is here

Register with Yahara Counseling Center, LLC today to start bettering yourself and finding a more peaceful path forward through therapy both online and in-person.

Register Now

COVID-19

In response to Covid-19, our physical office remains closed until further notice. We are monitoring the developments and following the CDC and World Health Organization (WHO) guidelines. Our office has transitioned to a HIPAA compliant Telehealth system. If you have any questions about Telehealth, please contact your provider. We are here to support you during this uncertain time and are committed to your mental health, comfort, and safety.