New Patient Information and Forms:
New patients must complete the new patient packet prior to a scheduled appointment.
The packet can be sent via DocuSign. Please send an email request to firstname.lastname@example.org
Please email a picture of your insurance card and photo ID so that our office can retain a copy for the patient file.
Also please be aware that the final page of the new patient packet can be filled out at any time.
It is an authorization to give consent for staff to be in contact with any third party for coordination of care.
Any patients who are over the age of 12 will need to sign each page when applicable.
If the patient is under the age of 12 a parent or guardian must sign all forms.
If you would like our staff to check your insurance benefits prior to your appointment,
please call the office with the insurance and policy holder information.
If you have any questions regarding the new patient packet please contact our office.
We look forward to meeting you and thank you for choosing Counseling Associates.