Forms

ALL CLIENTS need to complete the following forms:

1. Agency Record Form (for couples counseling, each person should complete this form)
2. Financial Form
3. Disclosure Form (Two Therapists’ Disclosure Forms are listed below. Others will be given at first meeting.)
   1. Ron Nydam’s Disclosure Form
   2. David DeBord’s Disclosure Form
   3. Werner Boos Disclosure Form
4. HIPPA Form

INSURANCE/EAP Clients need to complete the Insurance Form.

COUPLES THERAPY Clients need to complete the Couples Disclosure Form.

Are you working with your insurance company for your PCD services? Below is a list of helpful questions to ask your insurance company about your benefits.

Benefits Inquiry Questions