If you would like you may download the client intake forms and email your completed intake packet to ashley@mageemadrycounseling.com. Once your appointment is scheduled you will be able to access and sign all intake forms in the client portal. It is required that your intake forms are received at least 72 hours prior to your scheduled appointment or your appointment may be canceled. It is imperative your intake forms are received prior to your initial appointment in order for the therapist to prepare for our initial session and to verify your insurance.

 

Client Intake Packet

Intake Client Profile Intake Form

HIPPA Notice of Privacy Rights Disclosure

HIPAA Policy

Consent for Treatment

Payment Authorization

Your privacy is of the utmost importance to Magee Madry Counseling Services, LLC. Our agency complies with both federal and state laws related to patient privacy.

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    ADDRESS

    63739 street lorem ipsum City, Country

    PHONE

    +12 (0) 345 678 9

    EMAIL

    info@company.com