Client Forms

 

Click on the link(s) below to access our forms which can be filled out in advance.  Please print blank forms and THEN complete.  Also, if you are using insurance which a staff member accepts please complete the insurance verification form and fax in the download version to 214-509-6887.

                                      

                                      

            

                         

Children and Adolescents under age 18 (if parents’ are divorced).  Parent presenting child for counseling is required to bring a copy of the divorce decree proving they have medical/psychological rights to consent to treatment unless both parents appear at intake with their child.

 

 

 

Additional Forms

                                      

                                                                

 

 

 

Magellan EAP Forms (Value Options EAP, Cigna EAP and other EAP clients need not complete these)

 

                                       Client Info, Statement

 

Speaking Form

 

 

 

First Visit Paperwork

             Individual, Family, and Marriage Counseling

Insurance Verification

Confidential Exchange

Fax to 214-509-6887 before your first session.

This form is used for us to release information or obtain/exchange information with another party such as a doctor, school, or a previous counselor.