Intake Paperwork- Please fill prior to first appointment

In an effort to make your experience the best it can be, we want to make sure you have enough time to fill out the intake paperwork for your first visit.  We have made our intake paperwork fillable on the computer so you can type up your responses when it is most convenient for you.  Simple fill out on your computer and print for your initial appointment.  If you'd prefer not to fill out on your computer, you can print the intake paperwork and fill it out by hand or you can let us know and we can mail the intake paperwork to the address you provide.

*If you are going to be seen for couples counseling, please fill out the adult intake paperwork for each of the adults in the relationship.  If you are going to be seen for family counseling, please fill out the paperwork for the "identified client".

If you have any questions during this process, we are here to help.  Give us a call 608-783-1452.

 

Adult Intake Paperwork

Child Intake Paperwork

 

For Your Review- Please review prior to first appointment

Below is the paperwork for your review.  The therapist will touch on some of the main points in this paperwork at your first visit, so please review and ask any questions that you may have.  This file includes the Informed Consent to Treatment, Fees and Insurance Information, Privacy Practice Notice, Client Rights and Grievance Procedure Brochure, and the LWCFC Mission Statement.  This paperwork can be downloaded and saved to your computer or printed and filed as you see appropriate.

 

Client Paperwork - Policies/Procedures

 

Telehealth Forms

Telehealth related information can be found here.

 

Telehealth Client Letter

Telehealth Consent and Contact Form

Getting Started with Doxy.me

 

Release of Information- Blank

Blue Sheet