Counseling/Outpatient Services

Pine Rest offers outpatient, ambulatory care at 17 locations in Michigan and 2 locations in Iowa. Our clinicians provide a broad spectrum of quality care including counseling, consultation, assessment and testing for all ages in convenient, non-restrictive environments.

In addition to traditional outpatient care, Pine Rest also provides a variety of specialty services, including:


To schedule a new outpatient appointment,
call 866-852-4001.

NEW CLIENT FORMS

Please print out the appropriate New Client form below, complete and bring it to your first visit to one of our outpatient clinics. 

Adult New Client Information Form (Ages 18 and over)

Adolescent New Client Information Form (Ages 13-17)

Child New Client Information Form (Ages 12 and under)

 

NEW DBT CLIENT FORMS (DBT Clients Only) 

DBT Client History Form (new DBT clients only)

 

RELEASE OF INFORMATION FORMS (New or Existing Clients)

CLINIC LOCATION DOWNLOADABLE FORM

EXAMPLES OF HOW TO COMPLETE FORM

All Michigan Clinics Release of Information Form (Michigan) Michigan Example   
Des Moines, Iowa       Release of Information Form (Des Moines, Iowa)      Iowa Example
Pella, Iowa Release of Information Form (Pella, Iowa)



Text Message Appointment Reminders

Like what you read? Share this with your friends and family using the icons below.