Child Intake Forms
Innervisions Counseling & Consulting Center
Awareness of costs and financial responsibilities will minimize the time and stress related to the business side of your care. We strongly recommend that you contact your insurance carrier or agency before receiving services in order to become fully informed about your coverage (including your policy requirements, limits, and restrictions). We want you to maximize your financial benefits!
Your time is important to us, and since we have several forms for you to fill out prior to your visit, we have them listed here. We will let you know which forms we need you to fill out. This service is here so we can take best advantage of your time.
The forms are in two different formats:
- Forms that are fillable on your computer:
- Open each document and then save it onto your personal computer.
- Then open each document from your computer and begin filling it out.
- Use the “TAB” button to toggle to each input field.
- When completed, save the document back onto your personal computer.
- Attach each required/completed form in an email to firstname.lastname@example.org
- Forms you can fill in by hand:
- Obtain form copies from Innervisions office or print the “Forms you can fill in by hand” below
- Completely fill out the forms with a black or blue ink pen.
- Forms can be scanned and emailed to email@example.com
- Forms can also be brought to your Innervisions visit.
If you have any questions about anything on the forms, just leave it blank and we will assist you at the time of your appointment.
* Cancellation Policy: If you need to cancel an appointment, Innervisions requires a 24-28 hour notice or call.