
Please print all of the forms below to
bring with you for your first meeting with us. This will save you time in
our waiting room. If you are not greeted upon entering the building please make yourself comfortable in our
entry area. When your counselor becomes available, you will be welcomed.
(Please note - we do not have any available area or space for children to
wait. We do apologize. If your child is not going to be receiving services
it will be better for them to have other more suitable arrangements made.) Please read and
complete each form carefully and remember to initial the paragraphs where
indicated, along with your signatures.
Please pay particular attention to the "Regarding Insurance" and
"Stipulation" forms. Bring with you the required material outlined regarding
utilizing your insurance benefits, otherwise we will need you to pay the
full fee while you work things out with your insurance provider. We
apologize for the paperwork, but once we take care of these necessary items,
we can begin providing the care you need.
Note: If you are coming to us as a couple for counseling, each person will
need to complete all of the forms.
** These forms require Adobe Reader installed on your computer. Click Here to get it. **
Introduction to Lanier Counseling Services (LCS). Please initial all lines and sign as required.
Client Insurance and Billing Form. Please fill in all information, initial lines, and sign at the bottom.
Client Information Form. Please fill in to the best of your knowledge.
Confirmation of insurance policies. Please initial all lines and sign at the bottom.
Agreement that counseling remains confidential. All parties sign.
All above forms in one PDF File for printing.