Peace in the Midst of Conflict

Peacemaker Solutions

Office: (404) 644-5523, Fax: (770) 212-2210

                                          Client Forms

Basic Information and authorization form

Please click on the image above and complete the form, please print and sign and bring to next visit or email to your therapist at [email protected].  



Detailed Adult Client Information Form

Click on the image above to download the form to complete and submit to your therapist at [email protected].  Please complete and submit prior to your first visit.









Notice of Informed Consent

Click on the image above to download a copy of the contract for therapeutic services.  Please read carefully and complete all designated areas with initials and signatures and bring to your first visit.  


Child/Adolescent Client Information Form

Click on the image above to download the form to complete and submit to your therapist at [email protected].  Please complete and submit prior to your first visit.

HIPAA Forms


Click on the link to the right to download a copy of the HIPAA Notice and Privacy Practices.


Office Information

Peacemaker Solutions, LLC

Address

1905 Woodstock Road, Suite 7150
Roswell, GA 30075

Contact

Office:  (678) 582-1469
Fax:  (770) 212-2210

Hours

M, T, TH: 9:00 am - 7:30 pm
W & F: 9:00 am - 5:30 pm
Sat: 9:00 am -  3:00 pm
Sun: Closed

Social

1905 Woodstock Road, Roswell, GA 30075