Resources
Below are additional resources that we believe will be helpful to you. You can print and complete these forms before your first appointment or complete them in the client portal.
Forms
Informed Consent Contract
The informed consent contract covers all of the policies and procedures of Mended Wing Counseling. Please sign the last page. You can scan the signed contract and email back to the therapist prior to the first meeting, if it is easier for you. You may also sign this electronically via Adobe Acrobat, and email this back to your therapist directly.
Download
Notice of Privacy Practices
This notice describes how health information may be used and disclosed, as well as how you can get access to this information.
Download
Insurance Pre-Screen
The insurance pre-screen can be filled out electronically and emailed back to the therapist. If you plan on using insurance to pay for therapy, we will need to verify your benefits and eligibility prior to the first meeting.
Download
Release of Information
A release of information will need to be filled out and signed for your insurance company and any other providers, if applicable. You can scan the signed release and email it back to the therapist, if it is easier for you.
Download
Other Resources
Phone and Text Support
Suicide & Crisis Lifeline
No matter where you live in the U.S., you can easily access 24/7 emotional support.
Call or text 988 or visit 988lifeline.org/chat to chat with a caring counselor.
Learn More