Estar Counseling Services, Inc.
Therapy for Individuals, Couples, & Families
Estar Counseling Services, Inc.
D. Paul Rodriguez, Ph.D.

2562 Commerce Parkway, Unit 3
North Port, FL 34289

Billing:
P.O. Box 6728
North Port, Florida 34290

Office phone: 941.564.8734
Fax: 941.876.3452

D. Paul Rodriguez, Ph.D. specializes in Suboxone Treatment, Depression, Anxiety, School Issues, Marital Counseling, Stress, Workplace Issues, Divorce in the North Port, Sarasota County, Port Charlotte, & Charlotte County, FL areas. eTherapy services are also available.

Forms
If you're a new client, please complete the following forms and bring them to your first therapy session.

Demographic Information



Consent for Treatment



Notice of Privacy Practice



Client Psychotherapy Intake Form



L imits of Confidentiality/Therapy Cancellation Policy
 



Substance Abuse Forms:

Drug Testing Consent

 

DAST



MAST



Client Self Report1



Client Self Report2


If you would like me to coordinate care with another provider (for example, your psychiatrist, primary care physician, etc.), complete this form to authorize release of psychotherapy information:

Authorization to Disclose Information Form




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