Getting Started
Make an Appointment
To make your appointment with a new clinician or your first appointment in over a year, either complete the Individual First Form or the Relationship First Form depending on what type of counseling you are interested in. If you have any questions about the forms, please call us at 901-458-6291.
Complete Paperwork
To better serve your needs, please bring any additional applicable forms, along with your insurance card(s), to your initial appointment. These forms would be emailed to you from the CPC office after scheduling your first session.
Arrive for Appointment
On the day of your appointment, please arrive at CPC 15 minutes early for processing. We are located at 3950 Central Avenue Memphis, TN 38111
To complete a First Form digitally: 1) Open the form on a computer (not a smart phone). 2) Fill out the form 3) Download the form. 4) Email to intake@cpcmemphis.net 5) Wait for a call from our intake coordinator.
If you have any trouble filling these and would like to be sent a mobile-friendly version of the form, please email intake@cpcmemphis.net, and we will send you a link to the form within 1-2 business days of your request.
Patient Intake Forms
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If you are interested in one on one counseling sessions, please fill out the Individual First Form.
If you are filling this form out on behalf of minor, please list their demographic information and not your own. Testing for children ages 2-6 who have not completed kindergarten should complete the Early Childhood Clinic First Form.
This form can be completed digitally: 1) Open the form on a computer (not a smart phone). 2) Fill out the form. 3) Download the form. 4) Email to intake@cpcmemphis.net. 5) Await a call from our intake coordinator.
If you do not have access to a computer, you can print the form from a smart phone and submit a photo of the completed form to intake@cpcmemphis.net or come into our office to fill out a paper copy: 3950 Central Ave. Memphis, TN 38111.
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If you are interested in counseling sessions that involve more than one person, please fill out the Relationship First Form.
This form includes marriage, family and other relationships.
This form can be completed digitally by 1) Opening the form on a computer (not a smart phone). 2) Fill out the form. 3) download the form. 4) email to intake@cpcmemphis.net. 5) Wait for a call from our intake coordinator.
If you do not have access to a computer, you can print the form from a smart phone and submit a photo of the completed form to intake@cpcmemphis.net or come into our office to fill it out. 3950 Central Ave. Memphis, TN 38111.
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Por favor llene este formulario para programar una cita.
Additional forms will be sent to your email after your appointment is scheduled.
Please, bring applicable forms along with your insurance card(s), to your initial appointment.
If you have any trouble filling these and would like to be sent a mobile-friendly version of the form, please email intake@cpcmemphis.net, and we will send you a link to the form within 1-2 business days of your request.
Directions
3950 Central Ave, Memphis, TN 38111
Policies and Notification of Rights
CPC Practice Policies • Patient Notification of Privacy Rights