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Denise O’Doherty

Denise O’Doherty

Licensed Professional Counselor, Licensed Marriage and Family Therapist, Drug and Alcohol Counselor, Registered Nurse

  • Relationship Counseling
    • Couples Therapy
    • Marriage Counseling & Family Therapy
    • Premarital Counseling
    • Domestic Abuse Counseling
    • IMAGO Relationship Therapy
  • Substance Abuse
    • Alcohol & Drug Addiction
    • SALCE Evaluations
  • LGBTQ+
    • Lesbian Therapy
    • LGBTQ+ Couples Therapy
  • Other Areas of Practice
    • Anxiety/Depression
    • BiPolar Disorder
    • Codependency/Personal Boundaries
    • Grief Counseling / Grief Therapy
    • Love Addiction/Love Avoidance
    • Overcoming Shame /Increasing Self-Esteem
    • Post Traumatic Stress Disorder
    • Dissociative Disorders
  • Gender Identity
    • Parents of Transgender Children
    • Gender Dysphoria
    • Cross-Dressing
    • Adult Children of Transgender Parents
  • Articles

SALCE- Pre-Evaluation Forms

"*" indicates required fields

Your Name*
Your Address:*
MM slash DD slash YYYY
Is this report going to your Attorney?*
Is this report going to your Probation officer?*
Attorney Name:
Attorney Address:
Probation Officer Address:
MM slash DD slash YYYY
MM slash DD slash YYYY
Using the spaces below, please list any prior alcohol/drug related or any other arrests
Are you on medication now for any physical / mental health issues?
Current Significant Stressors: (other than this arrest)

I give my permission for Denise O’Doherty LPC, LMFT to release results of this SALCE EVALUATION and her summary, either directly, verbally, via fax, email or post office mail, to my attorney and /or probation officer.

Clear Signature
This field is for validation purposes and should be left unchanged.
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