Consent Forms for Adults:

Required to begin counseling services for adults using insurance:

1. Therapy Consent

2. Insurance Verification & Billing

3. Credit Card Authorization

4. Notice of Privacy Practices (HIPAA)

5. Telehealth Treatment Consent

6. Presenting Issues

7. Mental Health Screeners

Additional forms:

• GFE

• Insurance Opt-Out

• Payment Arrangement

• Sliding Scale Agreement

• Release of Information (External)

• Release of Information (Internal)

Consent Forms for Minors:

1. Therapy Consent (to be completed by the parent)

2. Presenting Issues (to be completed by the parent and the minor)

3. Privacy: Parent/Guardian of a Minor (to be completed by the parent)

4. Privacy: Your Rights as a MInor, and My Policies as a Provider (to be completed by the minor)

5. Mental Health Screeners for Minors