Welcome to Caring Couples, Happy Lives. In order for us to understand your situation quickly, we would like you to fill out a few forms. Be assured that the only purpose of these forms is to assist in your counseling. Please fill these out before your first appointment so your counselor can review in advance.

First Appointment (10 mins)

  1. Contact Permission
  1. First Session

a. First Session Adults (Age ≥ 18)

b. First Session Children (Age ≤ 17) Can be filled out by child or guardian

  1. Payment Authorization

Assessment (10 mins)

  1. Individual Assessment

a. Relationship Satisfaction

b. Feelings Checklist

c. Relationship Strengths

Consent (Only 1 form)

  1. Consent (Couples & Adults)

a. Elizabeth Sloan

b. Marika Martin

c. Kier Maxwell

  1. Consent (Families & Children)

a. Marika Martin

b. Kier Maxwell


  1. Health Information Release

a. All Clinicians

Additional Forms Your counselor may ask you to fill out these additional forms.

Thank you for your time in filling out these forms. We look forward to assisting you with your concerns.

Questions/Scheduling: 9am-2pm (M-F)
Appointments: 9am-8pm (7 days)
Call UseMail Us
Glenn Dale, MD / McLean, VA / Internet

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