CYNTHIA T MCCOY MS, LPC
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"Healing a wounded self,
to delicately remove 
traumatic chaos of the mind, 
and reclaim an authentic self 
​that was always meant to be." 
 


​Emotional Wellness Counseling PLLC


Forms

Please print and complete forms to bring with you to your initial session.  You may also email or fax them to me at:  cmccoyc@yahoo.com or fax (505) 557-6318
intake_and_history_form_ewc_11_21_.pdf
File Size: 59 kb
File Type: pdf
Download File

pdf_hipaa_notice_of_privacy_practices_ewc_2021.pdf
File Size: 44 kb
File Type: pdf
Download File

pdf_consent_for_treatment_ewc_2021.pdf
File Size: 16 kb
File Type: pdf
Download File

informed_consent_for_telehealth_2020.pdf
File Size: 131 kb
File Type: pdf
Download File

pdf_authorization_for_release_of_confidential_infomration_ewc_2021.pdf
File Size: 24 kb
File Type: pdf
Download File

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  • Home
  • Counseling services offered
  • Fees - Insurance
  • Contact
  • Forms
  • Links