The Steps to Becoming a Client

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This form overall includes information on the Therapeutic Process (including benefits/outcomes, expectations, risks, structure of therapy, length of therapy, fees, appointments/cancellation, trial, medical records, emergency procedure) and Confidentiality. 

This form is designed to gather pertinent information about the client's emergency contacts and procedures in the event of an crisis or urgent situation during therapy sessions. You will be required to submit two emergency contacts. 

This form is designed to detail the logistics of what it is to receive telehealth services and to help you navigate any hiccups that may occur.  

The HIPAA form is crucial document in therapy that protects client privacy, ensures informed consent, fosters trust and confidence, ensures legal compliance, and helps manage risks associated with the handling of sensitive health information. It Play a fundamental professionalism of therapy services while upholding the rights and privacy of clients. 

The billing agreement form serves to establish clear expectations, promote transparency, and ensure mutual understanding regarding financial matters related to therapy services. It helps facilitate a professional and respectful financial relationship between the therapist and the client, ensuring that both parties are aware of their rights and responsibilities regarding payment for services rendered.

A good faith estimate form is a document provided to all clients to outline the anticipated costs of treatment, including session fees and any additional expenses. It ensures transparency and helps clients understand the financial aspects of the therapy journey upfront, fostering trust and clarity in the therapeutic relationship. 

The personal medication list form is a document designed to help your counselor keep track of all medication you are taking. Awareness of your medications may help in recognizing potential behavioral or physical side effects, assess a drug's effectiveness, and assist in the tailoring of your therapeutic treatment plan. 

*This form is not included in the packet, but it is submitted upon request. This form is a requirement if you are wishing for your counselor to coordinate care with another provider (i.e. psychiatrist, PCP, OB-GYN, case manager, etc.). This can be your counselor receiving information from another provider of yours or your request for your counselor to convey information to another professional.