Patient Forms

For your convenience, all of our patient paperwork is available for you to download and complete using the links below.

New Patient Forms
If you are a new patient, you must complete our Welcome Packet PRIOR to your initial intake session.  Please read through these documents carefully before signing.  These documents cover our confidentiality and privacy policies, our payment policies, and our missed visit policies.  New patients who arrive to their scheduled intake session without the completed paperwork will have to be rescheduled due to time constraints.  So, please make sure to complete these forms and bring them with you to your first appointment along with your identification and insurance card.

Welcome Packet

Credit Card Authorization Form
For your convenience, you may provide your credit card, debit card, or HSA card to be stored securely on our safe and secure, HIPAA compliant electronic medical record.  One benefit of keeping your card on file is that your card can be processed before or after your appointments to decrease time spent in session collecting your co-payment fee.

Credit Card Authorization Form

Release of Information Form
To provide collaborative care, you may wish for your clinician to collaborate with another member(s) of your healthcare team.  Examples include primary care physicians, psychiatrists, family members, and teachers.  As mental health providers, we are required to maintain your privacy and confidentiality and we will only contact others with express written permission.  This form is completely optional for all patients.

Authorization for Release of Information Form

Inclement Weather Policy
For your safety and the safety of our staff, we may have to cancel or reschedule your appointment on occasion due to inclement weather.

Inclement Weather Policy

Scheduling Policy
Each clinician at the Clear View Counseling Center is an independent contractor and he or she has 100% autonomy over his or her schedule.  As such, please review our scheduling policy carefully.

Scheduling Policy

In-Person Treatment Informed Consent Form
This document contains important information about the risks related to initiate or resume in-person services in light of the COVID-19 public health crisis.

In-Person Treatment Informed Consent

Teletherapy Informed Consent Form
This document provides information about the risks and benefits of online mental health treatment.

Teletherapy Informed Consent Form