New Client Forms

The following client forms can be completed prior to your initial visit at New Directions Counseling Center. Please arrive 15 minutes early for your first appointment to complete additional forms located on the sign-in desk.

Adult Information Form (For clients 18 years and older)

Child/Adolescent Information Form (For clients 17 years of age and younger)

HIPAA (For all clients)

Release of Information Form (For all clients)

          • Please complete a separate Release of Information Form for each professional you would like for your psychologist to collaborate with regarding your treatment.
          • If you will be using insurance, please complete a Release of Information Form for your insurance company to give your permission for your services to be verified, authorized and your claims to be submitted.

          Insurance Benefits Form (For all clients. Please refer to note)

          Note: If you are planning to use insurance, you will need to call your insurance company prior to your first session. Please note that mental health coverage may be different from your physical health coverage. You can download our Insurance Benefits Information Form, which will provide you with the necessary information to gather from your insurance company in order to verify your benefits and authorize your services. Some insurance plans require prior authorization for your first visit that must be obtained by the client/parent. Failure to obtain prior authorization may result in denial of your claim. Please contact us if you have any further questions.