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Please fill out the following forms, and be sure to click "submit" on the form when you're done.  The checkboxes under the forms will reset if you refresh your browser even if your form has been submitted.  
Questions?  Text or email!  248.495.9322 or jmfc@jmfccounseling.com

Client Information Form

Client Information Form

Consent To Treat Form

Consent For treatment

HIPPA Form

HIPPA FORM

Brief History Form

Brief History Form
Payment Agreement Form

Jaime Collins is a Licensed Professional Counselor (LPC) in the State of Michigan. Services are only available to residents physically located within the states of licensure.

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Est. 2021, updated 2026

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