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New Feature: Complete and Submit Paperwork Online
New Feature: Complete and Submit Paperwork Online
Requirements for Initial Session:
- Telemental Health Consent Form
- Intake Paperwork*
- Verification of your Identity (ex. photo-id, driver's license, SS card, passport, etc.) *Link to submit included in intake paperwork
- Insurance card (front and back), if using insurance to cover session costs *Link to submit online with intake paperwork
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Additional Form:
Printable Forms
Printable Forms
Intake packet (information required for the initial session):
Notice of Privacy Practices (detailed information regarding government policies and regulations to protect your health information):
Release of Information Form (this form is used to provide authorization for release of protected health information to/from others):
Emergency Resources (list of available contacts to assist those who may be experiencing a crisis)
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Because You Matter Counseling PLLC
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