We look forward to welcoming you as a new client at Nutley Family Service Bureau!
We have been providing mental health counseling, social service programs and community outreach to individuals and families of Northern New Jersey and surrounding areas for over 100 years.
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Please complete the client registration form to the right. Please complete the client name field with the name of the person discussed during the pre-intake phone call. If the client is a minor, please complete the parental/guardian consent of a minor form to the right. If you have more than one child attending counseling, please complete the parental consent form for each child.
Please complete the appointment reminder form to the right. Choose one method of contact (email, phone or text) for appointment reminders, which you will receive approximately 48 hours prior to each appointment.
Please complete the Agreement to pay form to the right. If you have insurance, please use the standard fee form. If you do not have insurance, please use the adjusted fee form. Please also scan your insurance and photo id and email to NutleyFamily@nutleyfamily.org.
If you have children under the age of 12 that will be coming to the appointment, please complete sign the waiting area policy form to the right.
Please complete the Tele-Mental Health (Tele-Therapy) Informed Consent form to the right.