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©2021 Eola Counseling - All Rights Reserved
Dallas, Oregon
2200 East Ellendale
Dallas, OR 97338
Salem Oregon
401 E Ratcliff, Suite 130
Salem OR 97302
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New Patient Intake Forms
The online forms linked below are secure and easy to fill out. Please complete them prior to your first appointment. Our online forms are encrypted and
secured by a third party online. You may receive additional forms to complete when you visit our office. If you would prefer to fill these forms out offline
Contact Us and we will make other arrangements.