New Client Forms

new client forms

Please review, fill out and sign the four forms below. Bring the forms to your first appointment or email them to your counselor. First review the Notice of Privacy Practices before you start filling out the forms.

1. New Client Information Form

2. Billing Authorization/Insurance Information Form

*It is highly recommended that you verify your insurance benefits by calling your health insurance. You can use this guide to help you ask the right questions.

3. Service Agreement

We look forward to walking with you on your counseling journey.

Thank you

Mission

Provide access to mental health counseling services to individuals and communities from all walks of life.

Vision

Create a true integrative and holistic center for mental health services.

Values

  • Accessibility
  • Wellness
  • Culture