In order to begin counseling services, please print and complete the following forms, and bring them with you to your first appointment, along with your insurance card, if you are planning on utilizing your insurance benefits.
Step 1 - Client Services Agreement
Click on the button below marked Client Services Agreement, and review carefully. After reviewing the document, please print the entire document (a total of six pages), sign Page 6, and bring all six pages to our first session.
step 2 - Financial agreement
Click on the button below marked, Financial Agreement, print this form, sign, and bring to our first session. In order to reserve your session, you must also place a credit card on file through IVY Pay (you will receive instructions via text message after our initial phone consult). If a credit card is not placed on file at least 48 hours prior to your session, the session will automatically be cancelled.
step 3 - new client form
Click on the button below marked, New Client Form, print it out, and complete this document.
step 4 - insurance verification form
Last, if you are planning on filing your counseling services with your health insurance company, please click on the button marked, Insurance Verification, print this form, and follow the instructions. Please bring this completed form to your first session. In addition, please bring your insurance ID card with you to the first session. If you do not complete this form and bring it with you to the initial appointment, you will be charged the full contracted rate for each session until this step is completed.
You are done! Please review once more the instructions you received via text message after booking your appointment to make sure you have filled out the specific forms that I will need from you, and bring everything to your initial session (along with your insurance card if you will be using your health insurance benefits). If you have not yet done so, please also complete the process of placing a credit card on file through IVY Pay to confirm your appointment (you should have received instructions via a text message from IVY Pay after our phone consultation). I look forward to meeting you soon!
Bethany Comeau Counseling & Consulting
205 South Lee Street
Americus, Georgia 31709