First Time Clients
We have provided the PDFs in electronic format so they can also be completed using Preview (Apple) or Adobe Reader (Windows). Please Note: Some pop-up blockers may need to be disabled in order to allow the Save document window to open.
PRIVATE INSURANCE:
- AETNA
- AETNA EAP
- COVENTRY
- HUMANA
- HUMANA EAP
- MHNET
- MHNET EAP
- HARMONY
- GUIDANCE RESOURCES
- COMPSYCH EAP
MEDICAID
- SUNSHINE/CENPATICO
- WELLCARE
- STAYWELL
- HEALTHEASE
- STRAIGHT MEDICAID/FULL MEDICAID
- New Client Forms
You many download this form, fill it out at home, and bring it with you to your first appointment. - New Child/Adolescent Forms
Please download and complete this form when the client is under the age of 18. - Client Face Sheet /Information Update Forms
Use this form to help us keep our records updated with your current contact and billing information. Completed forms may be mailed, faxed, or dropped off in person. - Release of Information Forms
Due to confidentiality constraints, we cannot communicate with anyone about client information (even to acknowledge we are seeing a client) without the consent of the client (or parent/guardian of a client). Use this form to provide consent for your counselor to provide any information to a third party.