Children - Intake Forms for Shannon Himango, MA, LMFT & Suzanne Derheim, MA, LMFT

    Step 1 - Make an appointment by calling Anne Lied, office manager at 612-927-7335.

    Step 2 - Download, print & fill out the forms on the right for your child's age range ---->

    Step 3- Bring completed forms to session.   If you do not complete forms before coming to the Counseling Service, arrive15 minutes before session to complete forms in order to avoid using session time for formsYour information will kept confidential as mandated by law.