Please click on the appropriate LINK below to print your paperwork.
If you are scheduling for someone you have legal care of, Current Custody or Power of Attorney documents are required before scheduling. This helps us to
appropriately determine consent for care and access to confidential information.
Please submit the full document to the Client Registration office at 330-915-2364 or firstname.lastname@example.org
Please click HERE to read EMERGE Counseling Service's NOTICE OF PRIVACY.