Intake & Evaluation

To begin the Intake and Evaluation process, you can call or email our Billing and Intake Office using the contact information above.

Before your first scheduled appointment, you will need to complete a Client Intake Form and an Informed Consent Checklist, and submit them to our Billing and Intake Office. These two (2) forms can be accessed here:

CLIENT INTAKE FORM

INFORMED CONSENT CHECKLIST

When scheduling your first appointment with your counselor, you can ask about completing the remainder of the Intake and Evaluation paperwork beforehand. The remaining two (2) forms are the Brief Medical History and the Treatment Information Form. These two (2) remaining forms can be accessed here:

BRIEF MEDICAL HISTORY

TREATMENT INFORMATION FORM

Two (2) other documents related to your Intake and Evaluation process are a Notice of Privacy Practices and a Release of Information Consent Form.

 

The Notice of Privacy Practices describes your rights and legal guidelines regarding how your medical information can be used. You can read this notice at any time. Your counselor will also review it with you at the beginning of your therapy.

The Release of Information Consent Form allows you to voluntarily give your counselor permission to release confidential information in support of your therapy. For example, you may be asked to complete a Release of Information Consent Form that would allow your therapist to talk with a spouse or life partner, a psychiatrist, a primary care physician, a previous therapist, a school teacher, etc.

The Notice of Privacy Practices and the Release of Information Consent Form can be accessed here:

NOTICE OF PRIVACY PRACTICES

RELEASE OF INFORMATION CONSENT FORM

 

 

Locations:

Hanover  |   Hanson   |    Norwell    |    Brockton    |    Plymouth    |    Braintree

Phone:

781-826-0011

Extensions 108 & 112

Postal Address:

P.O.Box 2306

Hanover, MA 02339

Fax:

781-826-0012

© 2018 Institute for Spiritual Life & Psychotherapy, Inc.