• Client Portal

    1250 W. Ironwood Dr., Ste. 303 | Coeur d'Alene, ID 83814
    support@avaloncda.com | (208) 366-5053

    • Facebook
  • Avalon Counseling | Lonnie Stapp

    • Home
    • About
    • Counseling Services
      • Anger
      • Anxiety / Panic Attacks
      • Bipolar
      • Couples Counseling
      • Depression
      • Grief / Bereavement
      • Individual Counseling
      • LGBTQ Issues
      • Group Counseling
      • Obsessive-Compulsive Disorder
      • Online Counseling
      • PTSD
      • Trichotillomania
    • Getting Started
      • FAQs
      • Fees and Insurance
      • Social Media Policy
    • Blog
    • Resources
      • Useful Bits & Daily Mindfulness Sign-up
      • Physical Health Links
      • Mental Health Links

    Client Forms

    To access the form(s) assigned in your Welcome Letter:

    Please follow the directions below:

    • INITIAL VISIT FORMS (ADULTS) 

    (Forms 1 or 2, click on the link & enter your full name and email address).

    1.  Adult Initial Assessment

    2.  Office Policies & General Information

    3.  Privacy of Information Policies

    • LIST OF QUESTIONNAIRES

    4.  The Gottman Relationship Checkup    (Click on the link: Enter your first & last name and email address) 

    5.  Outcome Questionnaire (OQ-45)  (Enter your Medical Identification Number and DOB: mm/dd/yyyy)

    • CHILDREN & ADOLESCENTS

    (Enter your name (parent or guardian) and email address)

    6.  Adolescent Mental Health questionnaire

    7.  Children’s Mental Health Questionnaire

    8.  Parent Clinic Interview

    9.  Maternal Distress Questionnaire

    10.  Outcome Questionnaire (YOQ-2.0)   (Click on the link & enter your Medical Identification Number and DOB: mm/dd/yyyy)

    • SPECIAL CIRCUMSTANCES EVALUATIONS

    (To access a form click on the link and when requested enter my name Stapp, Lonnie and your unique client ID)

    11.  Post Traumatic Disorder Inventory (PTSI-R)

    12.  Sexual Dependency Inventory (SDI-4.0)

    13.  The “Betrayal Bond” Index Test (BBI)

    14.  Partner Sexuality Survey (PSS)

    15.  Sexual Addiction Screening Test (SAST)

    While convenience and thoroughness are important, confidentiality and security of your information remain a top priority.

    We designed the forms to assure your information remains private, secure, and HIPAA compliant.

    If you have any questions, suggestions, or technical issues feel free to call our office (208) 771-5510.

    1250 W. Ironwood Dr., Ste. 303
    Coeur d'Alene, ID 83814

    (208) 366-5053
    support@avaloncda.com
    fax: (208) 518.1258

    Contact Today


    Associations

    Website Redesign by Enleaf | Privacy Policy

    Avalon Counseling, LLC
    support@avaloncda.com | (208) 366-5053

    Copyright © 2021 · Brooklyn on Genesis Framework · WordPress · Log in

    MENU
    • Home
    • About
    • Counseling Services
      • Anger
      • Anxiety / Panic Attacks
      • Bipolar
      • Couples Counseling
      • Depression
      • Grief / Bereavement
      • Individual Counseling
      • LGBTQ Issues
      • Group Counseling
      • Obsessive-Compulsive Disorder
      • Online Counseling
      • PTSD
      • Trichotillomania
    • Getting Started
      • FAQs
      • Fees and Insurance
      • Social Media Policy
    • Blog
    • Resources
      • Useful Bits & Daily Mindfulness Sign-up
      • Physical Health Links
      • Mental Health Links