New Patient Form

Because counseling involves a professional relationship, we need to agree on the terms of our work together. Please complete a New Client Form, Child or Adult Form (if applicable), Communication Agreement Form, Consent & Confidentiality Agreement, Communication Agreement, Consent  for  Telepsychology,  Credit Authorization Form & Late Cancellation/Missed Appointment Policy Form. Please provide your photo identification and health insurance card when presenting the forms. If you have any questions and require clarification, please be sure to ask us.

Be sure to call the toll free number on the back of your health insurance card to find out if your plan includes mental health benefits. If mental health benefits are covered, ask for the following information:

• Number of sessions covered per benefit period

• Amount of the deductible and co-pay

• Authorization needed for your appointment

After you’ve completed your New Intake Forms, please submit them to schedule your appointment. You will need to bring your health insurance card and photo identification as well.

Regardless of the type of service, your first appointment is a time to meet with your treatment provider and discuss your concerns. The first appointment is a time for a thorough evaluation, and you will likely be asked a good deal of factual information about yourself. This might include things like the reason you’re seeking treatment, what your symptoms are, history of past problems and treatment, medical history, previous use of drugs and alcohol, and how some of the critical areas in your life are going (work, family, hobbies, etc.). This is also a time for you to evaluate your treatment provider to ensure that you feel comfortable with the person and the setting.

Our current late cancellation/missed appointment policy is unique to psychotherapy practices. We ask that you read it and consider it carefully to reduce the chance of misunderstandings that may hinder your progress in therapy.