Counseling Need-to-Know & Pre-Appt Forms

Step 2 – You may download and complete the “Pre Appointment Forms” ahead of your appointment or you can complete the forms in my office on the day of your visit (please arrive 15-20 minutes prior to your appointment if you need to complete the forms).

Click the below link to download the appropriate forms or request via email:

Client Forms Rev 072021– PDF File – Please download and complete and bring to your first session or Email to jancounsel@yahoo.com

HIPAA Compliant Notice – Please submit indicating you have acknowledged HIPAA Compliancy.

Client Forms as a Word Document – please request these forms be emailed to you. You may complete and email, prior to your first session to jancounsel@yahoo.com

Step 3 – Bring your completed forms, insurance card, and driver’s license to your first session. Cash, Check or Credit Card is acceptable for payment. The first session is an opportunity for you to decide if we are compatible for therapy. Building trust and rapport is an important element of the counseling process. It also provides me with an opportunity to feel confident that I can help you with your concerns/issues. You may ask any questions about me and my approach to counseling.

If you will be using Insurance benefits:

Step 4 – Prior to your first session, please contact your insurance company to verify your “mental health benefits” so you are aware of your co-payment, deductible and benefits needed for counseling.Visit Rates and Insurance for specific questions to ask your insurance company.

I look forward to meeting you and please feel free to contact me prior to your appointment if you have any questions.