When people wish to have the Center send or receive information about their care to another agency or provider, this form is an easy way to accomplish this.  This release form is secure and comes to us.

By far, the best website for information on mental health disorders, medications and treatment options.  It also has a page for quizzes on depression, anxiety, etc.

Online Questionnaires and Links


Your therapist may ask you to take one of our questionnaires to better assess what you may need in therapy.  These are not psychological tests; rather, they may indicate some emerging concerns that you may or may not be aware of.  Each of these questionnaires are designed on a secure format and they come right to us.

These questionnaires will be scored for our clients only.


​There are also helpful links to other questionnaires or websites.

Now that you have completed services with us, please encourage others who need hope, help and healing to contact Coastal Counseling Center!

Substance Abuse Counseling


Our substance abuse group is designed to assist clients reduce, if not quit, use & abuse of substances.  The group is based upon a psycho-educational model that encourages the sharing of information and ways to reduce and subsequently quit.

Satisfaction Surveys


Please complete the applicable satisfaction survey now that you have completed your counseling experience with us.  Click the button below that applies to you.

Anger Management Program


Our anger management program utilizes a curriculum where clients are required to bring this workbook to each session.  Workbooks are $5.00 each.  Please complete the Anger Questionnaire and the Anger Contract.

If you are required to complete Anger Management or Addictions Counseling, there are other forms required below.

First Time Appointments


Please click the appropriate button for the intake form:

Forms and Surveys


On this page, you will find all of the forms you will need for your counseling experience with the Center.  Some of the forms are necessary for your first visit and some your therapist may ask you to complete as they relate to your treatment.  These questionnaires are specific in nature and will help your therapist better understand and guide you.


There are also satisfaction forms that we use to assess how we are doing as we prove the best treatment for you.  These surveys are at the outset of counseling and at the end of your experience with us.  They are designed to help us improve our counseling services.

Call Us:  (912) 729-1120

Coastal Counseling Center 

Offsite Personality Questionnaires

(Clicking these two links will take you to other websites)


DISC Personality Inventory

This link will take you to a website to measure "behavioral" personality.  The website has a simple point, click & submit format that measures Directiveness, Inspiration, Steadiness and Compliance.  Once you click submit, the site will give you a Pie Chart with these four styles measured in percentages.  You will also receive a couple of pages of general information about your particular DISC style.


Modified MBTI Personality Inventory

This link will take you to a website that is an adaptation of the Myers-Briggs Temperament Inventory.  The website has a simple point, click & submit format that measures four domains:  Extravert vs. Introvert, Intuitive vs. Sensing, Thinking vs. Feeling, and Perceiving vs. Judging.  Once you click submit, the site will give you both a title (e.g., Reliable Protector, Idealist, Counselor, etc) and four slide bars that indicate your personality style (e.g., INFP, ESTJ, etc).  You will also receive a couple of pages of general information about your particular personality style.

Functional Assessment Scale (FAS-33)

This questionnaire is designed to measure difficulties in relationships, daily role & obligations, depression, anxiety, and risk behaviors.


Perceptions Questionnaire

This questionnaire is designed to assess ways of thinking and perceiving when it comes to people, events, beliefs and relationships.


Learning Style Assessment

This questionnaire helps you to assess your learning style, whether auditory, visual, kinesthetic or a combination of the three.


Impact of Event Scale

This questionnaire is designed to measure one's level of distress after witnessing or experiencing a traumatic event.


Youth Anxiety Scale
This questionnaire is designed to measure a child or adolescent's level and type of anxiety.


Depression, Anxiety, Stress & Anger Scale

This questionnaire is designed to measure one's perception of depression, anxiety, stress and anger upon an individual.


Self-Image Scale
This questionnaire is designed to measure one's perception of his or her image of self / self-esteem.


Do I Have a Healthy Relationship?
This questionnaire is designed to help you assess the health of your intmate relationship.


Am I in an Emotionally Destructive Relationship?

This questionnaire is designed to help you assess the patterns of emotional destructiveness in your relationship.


Satisfaction in Marriage Questionnaire

This questionnaire is designed to measure one's perception of happiness in the relationship.


Relational Closeness Questionnaire

This questionnaire is designed to measure one's attachment style in an intimate relationship - whether close or distant.


DISC Profile

This questionnaire will assist you in understanding your personality related to your behavior.  It will assess how you approach problems, people, your pace in life and how you handle procedures.


Modified Myers-Briggs Profile

This questionnaire is designed to assess your personality style in how you invest your energy in others, what information catches your attention, your decision-making style and the "environment" where you are most comfortable.