Thank You – Form Completion

Thank you for submitting your New Client Information Form. There are just two more steps to complete the process:

Step 2: READ the following documents carefully:

  • Consent, Disclosure, & Policies Form – Each adult will sign one of these forms during their first therapy session. You do not need to bring a copy of this document with you, as we will provide the form for you to sign (either electronically or on paper).
  • HIPAA Policy (Federal Requirements Regarding Confidentiality)

Step 3: Please check if any of these additional circumstances apply to your situation:

  • If you need your therapist to share any information with an outside party, you will have the opportunity to sign the Authorization to Release Information Form during your appointment.
  • If you are a parent/legal guardian of a minor who will be attending therapy, and if you will not be present to pay for each session, please print and complete this Credit Card Authorization Form and have your child/teen bring it to their therapy session.

 

 

List of All CCC Forms:

  • Consent, Disclosure, & Policies Form: All adults will sign this form at their first therapy session. Please note that each adult participating in therapy will need to sign a separate form.
  • HIPAA Policy: All clients should read CCC’s policy of compliance with Federal Requirements Regarding Confidentiality.
  • Authorization to Release Information Form: If you need your therapist to share any information with an outside party, please fill out this form online here. If you would prefer, you may also print out this form and bring it to your appointment. If you are attending couples or family therapy, all adult clients will need to sign this form.
  • Credit Card Authorization Form: If you are a parent/legal guardian of a minor who will be attending therapy, and if you will not be present to pay for each session, please print and complete this form and have your child/teen bring it to their therapy session.