8022B North 2nd Street
Machesney Park, IL 61115
ph: (815) 299-1600
info
If you are a first time client please review and complete the new client information form prior to your first scheduled session. Please bring it with you to your first session.
New Client Information Form pdf
New Client Information Form doc
New Client Information Form docx
If you would like the Relationship Resource Center to coordinate your care with other treatment providers (for example, your psychiatrist or primary care physician), please review and complete this authorization to exchange and release information and bring it with you to your session.
Authorization for Release of Records pdf
Authorization for Release of Records doc
Authorization for Release of Records docx
If you would like the Relationship Resource Center to coordinate your care with a family member or if you would like specific information about your treatment released to a family member, please review and complete this release of information for family members and bring it with you to your session.
Release for Family Members pdf
All of the forms on this page are available in three file formats. If you are using Microsoft Office 2007 or newer, you may download the .docx files. If you are using an older version of Microsoft Office, you may download the .doc files. If you are using a different program, please use the .pdf files.
You will need Adobe Acrobat Reader to download the .pdf files. If you do not have the ability to download .pdf files, please click here to download Adobe Acrobat Reader.
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Claire Bluhm, M.S., ALMFT
Associate Marriage and Family Therapist
Owner
Visit the Relationship Resource Center Blog
Claire L Bluhm is listed at AllTherapist.com and is the co-founder of Rockford Illinois Area Mental Health Network
Copyright 2010 Relationship Resource Center. All rights reserved.
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The Relationship Resource Center specializes in professional counseling services in the Rockford,IL metro area. Services include marriage counseling, premarital counseling, family therapy, psychotherapy, mental health counseling, counseling, and couples therapy. If you are experiencing relationship problems, conflict, infidelity, depression, stress, anxiety or just need someone to talk to, please call us today at (815) 299-1600.
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8022B North 2nd Street
Machesney Park, IL 61115
ph: (815) 299-1600
info