FORMS & DISCLOSURES
Prior to your scheduled appointment please complete the appropriate paperwork as well as your counselor’s professional disclosure below. We ask that you bring these forms and your insurance card to your scheduled in person appointment or email for telehealth sessions. Contact admin staff for email instructions. If emailing, the forms and insurance card must be submitted 24 hours before the appointment.
All NO SHOW and late cancellation appointments will be billed at the full rate. These fees are not billable to your insurance. Fees must be paid before your appointment can be rescheduled. If you are a first time client and give us less than 24 hours notice about rescheduling your appointment, we will not reschedule you again in our office.
TO SIGN DIGITALLY:
Download the file to your computer or device and open in a PDF viewer such as Adobe Acrobat. After signing, save the file with a new name. For in-person sessions, print and bring the forms with and for telehealth sessions, contact the admin staff for instructions on how to email.
- Click the Download button of the form to be filled out. Download and save the file to your device.
- Open the file in Adobe Acrobat or a pdf viewer program. Fill out the fields with your information and digitally sign the form.
- Once you’ve completed all fillable fields, click ‘File’ > ‘Save As’ in the navigation.
- Add your first and last name to the file name. Click Save.
NEW CLIENT FORMS
Professional Disclosures *new clients, please complete:
Locate your counselor in the list below and click their name or download button to open and download their professional disclosure.