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FORMS

Here is a list of potential forms you may want to access related to services at WTC. If you are unable to open or access the forms please contact: support@willowtreecounselingfm.com

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*Note: If you are completing forms on behalf of someone else, please know that we must verify information with the primary client (or legal guardian). 

Intake Forms for First Appointment

2

Screening Assessments

Depression: PHQ-9

Anxiety: GAD-7

Mood/Bipolar: MDQ

Trauma: PCL-5

Substance Use: CAGE-AID

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Information & Record Requests

4

Referring Providers & Agencies

For providers and agencies wanting to refer a client to WTC, please complete the referral form & fax required information to 

(701) 552-7975.

For questions related to external referrals, please call (701) 730-8313 ext. 1.

​Location

102 W. Beaton Dr., Ste. 103

West Fargo ND 58078-2653

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Phone:

(701) 730-8313 

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Fax:

(701) 552-7975

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Email:

support@willowtreecounselingfm.com​

Willow Tree Counseling

Office Hours

​​​Monday

Tuesday

Wednesday

Thursday

Friday

Saturday

Sunday

​9:00 am - 6:30 pm

9:00 am - 6:30 pm

9:00 am - 5:30 pm

9:00 am - 5:30 pm

Closed

Closed

Closed

​*By appointment only

**Hours may vary from listing

Willow Tree Counseling   |   â€‹www.willowtreecounselingfm.com

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