Download Forms

Below are links to the counseling forms which new clients need to complete and either return to the Prestonsburg office prior to scheduling an appointment, or bring with them to their first appointment at the Lexington office.

 

All new clients must complete the Application for Services
and the Clinical Counseling Agreement

 

 

Please complete the Insurance Form
if you have insurance which you would like to use to pay for your counseling.

 

 

Please complete the Release of Information
if you have previous counseling records that you would like us to have.

 

The Notice of Privacy Practices is for your information only and does not require completion.

DIRECTIONS TO OUR OFFICES

Abajo hay enlaces a los formularios de
 asesoramiento que los nuevos clientes 
necesitan para completar y regresar a la
 oficina de Prestonsburg antes de 
programar una cita, o llevarlos a su 
primera cita en la oficina de Lexington.
 

Todos los nuevos clientes deben completar

  la Solicitud de Servicios Y el Acuerdo de Consejería Clinica 

 

es para su información solamente y no requiere ser completada.


Lexington Office:

1310 West Main Street Lexington, KY 40508-2048
Phone: (859) 253-1993 - Fax: (859) 255-1134

Prestonsburg Office:

60 Martha's Vineyard Prestonsburg, KY 41653
Phone & Fax: (606)874-9170