• Mon to Fri: 9:00am to 6:00pm
  • 10850 Sam Black Road, Suite B, Midland, NC 28107
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+1(704)890-8112

Forms

  • Home
  • Forms
UnTalk – stop talking and startcommunicating
Stop Your Fighting Tonight! Video Course
Conflict Intensive
Relationship Rescue
How to Break the Pursuer-Distancer Pattern
Is your couples counselor sabotaging your marriage?
Why Your Diet May be Hurting Your Relationship
Is your couch killing your sex life?

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Forms

Before your first appointment with Phil DeLuca, please fill out the following forms:

Credit Card Information Form

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Notice of Privacy Practices and Receipt of Notice Form

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Informed Consent Form

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Medical and Health History Form

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Client Information Form

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Professional Disclosure and Information Form

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  • Therapy Timing:
  • Monday to Friday 8:00am - 6:00pm
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Couples counseling and psychotherapy in Midland, North Carolina. Accepting clients from the Monroe, Concord, Indian Trail, and Mint Hill areas.
I specialize in issues related to men, seniors, stress reduction, and relationship problems.

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Deluca Counseling 10850 Sam Black Road, Midland, NC 28107

Send Email

delucalcsw@gmail.com

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+1(704)890-8112

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