© 2019 Cedar Valley Counseling Services

FORMS

Prior to your initial appointment:
Please review and complete our New Client Form, HIPAA Privacy Notice, and Client Informed Consent 
(found below) and bring them with you to your first appointment.
If you so choose to automatically make payments (co-pay, deductible co-pay, or out of pocket fee)
please fill out Electronic Payment Authorization form.
We suggest calling the member services number on the back of your insurance card to verify your mental health (also called behavioral health) coverage and benefits. Some companies require prior authorization through them to cover sessions. To avoid paying full service fees that would normally be covered by your insurance, verify benefits beforehand. 


If the client in a minor, a parent or guardian will be responsible for necessary paper work

and any additional release forms.