Forms

We recommend for all new clients to check with their insurance company prior to the initial appointment to verify coverage for services. Occasionally, insurance companies will have different rules and coverage for mental health services.

Please note: If you are using insurance you MUST provide proof of insurance (insurance card and photo ID) at your initial session. If you are unable to provide proof of insurance, you will be expected to pay the full session amount before being seen by the therapist. Once proof of insurance is provided, we will gladly submit the claim to your insurance company.


Adult Intake Form (pdf)

* This form is for individuals over 18. For couples/marital counseling, please have both parties fill out their own separate form.

* For those parents who are still involved with their 18- or 19-year-old child, please feel free to fill out the Child/Minor Intake form as well. All information will be helpful in treatment; however, the legal age of 18 will prevent disclosure of information shared in sessions.


Youth Intake Form (pdf)

* This form is for the parent/caregiver of the client to fill out. If the client is 16-18, he/she can also fill out the Adult Intake Form if he/she feels they want to share information themselves.


Our Privacy Practices (pdf)