Forms and Agreements

Family

If you're a new client, please read the following thoroughly prior to your session. 

Note: During Covid-19 all sessions are conducted virtually for the safety of our community.  During this time all paperwork is to be completed electronically or if you prefer to submit a hard copy you can do so in person, by fax (614-437-4075) or emailed to ([email protected]) within 48 hours prior to your scheduled appointment. We do not accept photos of paperwork at this time.  Please note that we are willing to meet face to face to collect paperwork if you aren't comfortable with sending documents electronically. Emails we send are encrypted. Emails sent to us are not unless you have encrypted them. 

Virtual/Video Platforms:  Doxy.me, Therapy Notes or Psychology Today.  Please notify your therapist of any preference you may have.  All of the video platforms used above are HIPAA compliant. 

Documents to bring/provide: Please bring/present your insurance card and a government issued photo identification.  The insurance information needs to be provided 48 hours prior to your scheduled appointment so that we may verify coverage details. Note: It is your responsibility to ensure that Liberty Counseling and Consultation is a participating provider with your insurance or managed care company prior to beginning services. Remember, In Network Status isn't a guarantee of payment by insurance companies/managed care. The patient/client is responsible for all cost incurred by them for counseling services. We bill insurance and managed care companies as a courtesy. Additionally, Liberty  Counseling and Consultation reserves the right to refuse secondary billing and it reserves the right to collect full payment for the service at the beginning of each session prior to billing insurance companies. 

Appointment Time and Grace Period for our therapist: Your appointment will start within 15 minutes of your appointment time.  This is a grace period for therapist in case he/or she runs over in the previous session or needs an extra moment to prepare for your session. This means that your 1:00 pm appointment will start no later than 1:15 pm.  We will initiate the call. Please do not worry. We will be with you shortly. Thanks for your patience. 

Forms: To be completed electronically through TherapyPortal once Liberty Counseling and Consultation grants you access.  You reserve the right to complete hard copies of the documentation.


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Availability

Primary

Monday:

Flexible Appointment Times Available. Contact Us for More Information

Tuesday:

Flexible Appointment Times Available. Contact Us for More Information

Wednesday:

Flexible Appointment Times Available. Contact Us for More Information

Thursday:

Flexible Appointment Times Available. Contact Us for More Information

Friday:

Flexible Appointment Times Available. Contact Us for More Information

Saturday:

Flexible Appointment Times Available. Contact Us for More Information

Sunday:

Flexible Appointment Times Available. Contact Us for More Information