Inpatient Forms

Forms for Therapy with Peace of Mind Counseling

"We look forward to meeting you and supporting you on the healing journey ahead. Before we get started, please print out, read, and complete the following client forms. You will bring these with you to your first session. You can find directions and a map to our office in Downtown Lacrosse, WI under the contact tab."

Personal History Form

Informed Consent and Summary of Rights

Client Intake Form (page 1)

Client Intake Form (page 2)

Notice of Privacy Practices

Peace of Mind Counseling

Getting in Touch

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Outpatient Therapy

All of our therapists offer professional yet personal, individualized treatment and creative solutions for a wide range of mental health problems and emotional or behavioral health concerns.

We accept many insurances and Medical Assistance for payment, and also offer a Self-Pay rate.

In-School Therapy

Peace of Mind Counseling, LLC is certified by the State of Wisconsin to provide Outpatient services in several local school districts. State certification permits us to conduct counseling sessions on site at a youth's school.

Financial obligations must be met by the youth's parents' insurance or Medical Assistance, not by the school district. Permission is granted on an individual basis.

In-Home Family Therapy

Peace of Mind Counseling is one of the few area agencies offering this service to families of youth who exhibit severe emotional disturbances. Our therapists work from a systems perspective to assist parents with managing these challenging children. We also address ineffective family dynamics.

LaCrosse Office

Peace of Mind Counseling
115 5th Ave. So. Suite 523
La Crosse, Wisconsin, 54601
(608) 797-5679
(608) 782-4426

LaCrosse Hours

7:30am - 7pm Monday - Thursday
7:30am - 4pm Friday
Weekend by Appointment

Winona Office

Peace of Mind Counseling
902 East Second Street, Suite 322
Winona, Minnesota, 55987
Phone: (608) 797-5679