Intake for Parents

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By signing the following document electronically, it is to be the legally binding equivalent of your individual handwritten signature. 


New Client Information

Contact Information

I give my permission to Compassion Counseling for the treatment of my child. 

Other Information:

Emergency Contact Information:

In the event of an emergency, please contact:

Presenting Problems:

Counseling and Psychiatric History:

Medical History:

Marital Status:

Household Information: (list all who reside in the home)

Substance Abuse History:


If you are a licensed counselor, a counselor intern or interested in individual or group supervision and would like to join our team, please contact us.

Meredith Akin-Ivey, is a Licensed Professional Counselor-Supervisor and a Registered Play Therapist- Supervisor.  Please E-mail or call her for more details.

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Compassion Counseling
2214 Michigan Ave
Suite F
Arlington, Texas

Phone: (817) 723-1210

Fax: (866) 776-5116

Our Specialities

At Compassion, our counselors have experience counseling a variety of issues including but not limited to: adoption, anxiety, abuse, body image, depression, couples, faith, families, grief, play therapy, parenting, teens, trauma, christian sex therapy, and self-esteem. Please call our office for more information regarding each counselor's specialty.