New Client Forms For Counseling In Center City, Philadelphia PA, Ocean City NJ, Santa Fe NM, Alpharetta GA, Mechanicsville VA and Telehealth in Florida.
FORMS : INDIVIDUAL COUNSELING
- Client History Form,
- Client Information Form,
- Payment Authorization Form,
- Consent For Services,
- Good Faith Estimate Form,
FORMS: COUPLES COUNSELING
- Client History Form,
- Client Information Form,
- Payment Authorization Form,
- Consent For Services,
- Good Faith Estimate Form,
- Confidentiality Request,
FORMS: CHILDREN AND TEEN COUNSELING
- New Client Form,
- Child Personal Data Form,
- Child Agreement,
- Parent Agreement,
- Payment Authorization Form
- Good Faith Estimate Form,
- Confidentiality Request,
FORMS: FOR COORDINATING CARE
COSTS:
FORMS: INSURANCE
- We are out of network with all insurance companies.
- To determine your out of network rates
New Client Forms For Virtual Counseling
- After scheduling an appointment all of your forms that you need to complete will automatically be sent to your email. These forms will be "responsive" and you can fill them out online without needing to print them first. You can then send them back to us using your secure client portal. All of the above forms must be printed and manually filled out.
If you choose to Fax or snail mail the forms back to us, please let your therapist know that you are doing so. If possible, we prefer that you upload the forms directly into our secure virtual portal. Your therapist can explain the process to you.
Old Style Communication (that works, we just aren't in the office every day)
Fax: 215-922-6302 (for the whole practice)
Address: Center For Growth
Attention: Telephone Counseling Department
233 S 6th Street, Suite C33,
Philadelphia PA 19106