Cynthia Dowdy Herlong, Phd

Licensed Professional Counselor

Phone: 919-349-2146
Fax: 919-786-0604

Intake Forms

Printable versions of the forms are available below. If your software does not allow you to read them, click here to download the free Adobe Acrobat Reader.


Available At Your First Appointment

The Notice of Privacy Practices (HIPPA) and my Professional Disclosure Statement are available at my office for your review.  You will be asked to sign that you have read and agree to these statements at your first appointment.

Print All Forms

Print All Forms, Complete, and Bring to 1st Session.

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