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A New Parenting Approach
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Home
Forms
Contact and Map
Publications
Services
A New Parenting Approach

Gary Unruh, LCSW

Gary Unruh, LCSWGary Unruh, LCSWGary Unruh, LCSW

New Client Forms

Client Information (pdf)Download

Policy for Payment (pdf)Download

Disclosure (pdf)Download

Insurance Authorization and Guidelines (pdf)Download

Authorization to Release Information (pdf)Download

Client History Forms

Adult History Form (pdf)

Child History Form (pdf)

As a new client, you must review and understand your client rights: Health Insurance Portability and Accountability Act of 1996 (HIPAA).

More information can be found on the U.S. Department of Health & Human Services website by CLICKING HERE.

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