Rossana Counseling

Couples and Family Counseling

Call or Text 336-543-6624
Counseling Offered in English and Portuguese
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Forms

MBSR Forms: Mindfulness-Based Stress Reduction – Collaborative Program

Please, return the forms at your earliest convenience and before class ONE.

As you click the link below, the document will be downloaded on your computer. You can find it inside your download folders or searching for Stress Scale and Inform Consent to Record. Click on the document and it will open up with Word Doc.  If you feel comfortable filling out on your computer, please do it and send it by email to contact@rossanacounseling.com. If you would rather use a pen, you can print it out, complete it and use your phone or printer to scan and send by email also to contact@rossanacounseling.com. Please, read them carefully and fill up all questions. Thank you for your collaboration.

Stress Scales

Inform Consent to Record

COUNSELING FORMS:

Please, download, print, and fill up the forms before the session, if possible. All forms are meant to give you and your family complete information about the services you will get and your rights as a client. Please, read them carefully and fill up all the information. You do not have to rush, you have time until our first appointment. Thank you for your collaboration.

Self Pay and Private Insurance Intake Forms for clients

Medicaid Intake Packet for clients

Family Solutions Consent to Record

Rossana Professional disclosure statement

Intake Form Rossana Counseling

Rossana Professional Disclosure Statement for Couples

Rossana Counseling Notice of Privacy Practices 

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Call or Text 336-543-6624

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About Us

Rossana Counseling
Rossana Magalhaes, MS EdS

Certified National Counselor
Board Certified Counselor
Board Certified Telemental Health Counselor

Greensboro, NC 27401

Diplomas & Certifications

National Certified Counselor
Licensed Professional Counselor Associate
Member of the American Counseling Association 
Member of the North Carolina Psychological Association
Member of the North Carolina Licensed Professional Counselors Association - NCLPCA
Member of the International Centre for Excellence in Emotionally Focused Therapy

Baord Certified Telemental Health Provider

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