(225) 347-0773 | awyles21@gmail.com

Soul Anchor Counseling, LLC

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Client Forms

Please be sure to fill out the following forms and bring them to your first session. This will help ease you into therapy and allow as much time as possible to focus on YOU. In addition to the forms below, I have clients fill out an Anxiety and Depression screen their first session, so arriving a few minutes early is helpful.  Please note: If I am in session, the forms will be placed in the reception area with your initials on them. The goal is to help streamline your initial counseling experience so thank you for your help! If you have any questions regarding the forms below, you can email me and/or we can discuss your questions during your first session as well.

SAC Adult Information Intake Form

New Client Information form

Notice of Privacy Practices

Acknowledgement of Privacy Practices

Declaration of Practices and Procedures

Authorization for Release of Information

Limits of Confidentiality

Setup an Appointment

Patricia Aline R. Wyles, LCSW



(225) 347-0773
awyles21@gmail.com

7100 Amite Church Road
Denham Springs, LA 70706

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By submitting this form via this web portal, you acknowledge and accept the risks of communicating your health information via this unencrypted email and electronic messaging and wish to continue despite those risks. By clicking "Yes, I want to submit this form" you agree to hold Brighter Vision harmless for unauthorized use, disclosure, or access of your protected health information sent via this electronic means.

Office Hours

Wednesdays and Thursdays 9:00am to 5:00 pm *other days are varied
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Contact Information

7100 Amite Church Road
Denham Springs, LA 70706

(225) 347-0773
Office Fax: 225-380-2197

awyles21@gmail.com

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