Spira Counseling

A place of healing and growth for the many unexpected turns in life. Whether you are seeking subtle change, radical new direction, or support just where you are, we are here to aid your journey.

"Those who are willing to be vulnerable move among mysteries".
-Theodore Roethke


The counselor disclosure and informed consent document gives you information regarding licensure, client rights and responsibilities, rates, and privacy policies. Should you choose to begin services with Spira Counseling, you will download and sign a copy of this document indicating your consent for treatment, your agreement to financial terms, and acknowledgement of receiving this information. You may scan, or take a picture of the document and send it via email at kapugi@spiracounseling.com (please keep in mind that if you fill the document out electronically, you will need to upload an image of your physical signature). You may also mail a physical copy. I will keep a digital copy of your signed document.

Counselor Disclosure Form

Our first session will be about gathering information and creating a treatment plan that is right for you and your needs. Please fill out the personal history form as best as you are able. You may fill this document out electronically and send to kapugi@spiracounseling.com; alternatively you may photo image or scan and send via email or send to a via mail. If you are sending via physical mail please send five days prior to your intake session.

Personal History Form