Forms

Interested in joining our network of Affiliate Counselors?


Far West contracts with licensed mental health counselors to provide counseling in areas not covered by our service areas. The majority of our clients are seen in our private offices in Renton, Lynnwood, North Seattle, and South Everett. We welcome counselors of color.

 

Please start with the Introduction for more information on the role of Affiliate Counselors. If you are interested in joining our network, fill out the application form and return to diana.nielsen@comcast.net with a copy of your resume. You will receive a follow-up call from Diana Nielsen, business manager.

 

Thank you for your interest. Please call us if you have any questions. 206-682-8149.

Click on form below to download a PDF file in your browser.

Form for Employers

Mandated employee referral

To refer a mandated employee, download the Authorization to Disclose Personal Information form and have the client sign and check appropriate boxes. Fax the signed form to Far West along with any disciplinary reports or documents to 425-582-8748.

Asian woman counselor

"If you have knowledge, let others light their candles at it."
                               Margaret Fuller

Heart shape made with hands