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, and 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. The Release of Information Consent Form allows you to voluntarily give your counselor permission to release confidential information in support of your clinical care. These two forms can be accessed here:

NOTICE OF PRIVACY PRACTICES

RELEASE OF INFORMATION CONSENT FORM

 

 

Locations:

Hanover  |   Hanson   |    Norwell    |    Brockton    |    Plymouth

Telephone:  781-826-0011 extensions 108 and 112
 

© 2018 Institute for Spiritual Life & Psychotherapy, Inc.