EACH client must complete this form. There are 12 pages, so please give yourself plenty of time.
Individual Client Information includes:
- Client Intake (4 pgs)
- General Information and Consent for Therapy (2 pgs)
- Policy, Fees, Payment, Insurance, & Scheduling (1 pg)
- General Consent for Communication Guidelines (2 pgs)
- General Consent for Telemental Health Communication (1 pg)
- No Surprises Act (1 pg)
- Notice of Privacy Practices (HIPAA) (1 pg)
Couples should complete the Individual Client Information Forms AND the Couple Client Information form.
There are 19 pages, so please give yourself plenty of time.
1. Individual Client Information (12 pgs)
2. WTCC Couple Client Information (7 pgs)