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Old Mill Center

for Children and Families

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Forms for Counseling Clients

Welcome New Clients!

To begin utilizing our Counseling services, please call 541-757-8068 and speak with our Intake Coordinator. After completing our phone intake, complete and return the appropriate forms below prior to your initial appointment/mental health assessment.

Return forms to Lisa Field, Intake Coordinator & Clinical Specialist via:

  • Email
  • Fax: 541-758-1030
  • USPS mail or Old Mill Center mailbox drop-off: 1650 SW 45th Place, Corvallis, OR 97333

New Client – Minor (under age 14 years)

Parent/guardian, read and review:
• Counseling Services Information Packet
• Privacy Practices Booklet

New Client – Teen or Adult (age 14+)

Please read and review:
• Counseling Services Information Packet
• Privacy Practices Booklet
• Client Rights

Current Clients – Grievance Process

Old Mill Center continually strives to provide the highest quality of care. If, however, you have a concern regarding your counseling experience, we encourage you to submit the following form at any time. We will respond in writing within 20 calendar days.

  • Grievance Form

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1650 SW 45th Place
Corvallis, OR 97333
541-757-8068

Privacy Practices Booklet

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