Please click on the below link and print ALL registration papers. Please print clearly and BRING THEM WITH YOU to your first appointment. If you are not able to complete this ahead of time, please come 15 MINUTES EARLY to complete them in the waiting area so that you can start your appointment on time.
Your therapist cannot meet with you until you have provided the completed forms.
- Face Sheet
- Basic Rights and Consent to Treatment
- Client Acknowledgements
- Patient Policies, Procedures & Orientation to Center
- Financial Policy
- MD Release Letter
- Credit Card Authorization
Required Insurance Form
If you plan to use insurance benefits to help you pay for your counseling this form MUST be completed 36 hours before your appointment. You must make an appointment with a therapist first.
Please complete the above form as accurately as possible. This will assist us in verifying your Insurance Benefit information. Please be sure to bring your insurance card AND Identification (i.e. driver’s license or passport) to your first appointment.
It is most important that you call your insurance company yourself to confirm what your benefits are specifically. A quote of benefits from your insurance company is never a guarantee of payment.
Your information is confidential and it is secured with us.