KIT JONES, M.Ed., Licensed Professional Counselor

YOUR NEW BEGINNING. Culturally Sensitive Help for Your Issues—If not now, when?

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Forms

     These are the forms required for new and returning clients.            
 
Client Package        <-- Click here
 
If you have trouble opening this file, please go to Adobe's Website http://www.adobe.com and download the free Acrobat Reader.
Then return to this page and click the Client Package link.
 
ONCE THEY ARE PRINTED, CAREFULLY READ OVER THESE FORMS AND SIGN OR INITIAL AND DATE WHERE INDICATED. YOU WILL NEED TO BRING THEM, ALONG WITH YOUR DRIVER'S LICENSE OR IDENTIFICATION CARD WITH PICTURE, INSURANCE CARD IF USING HEALTH INSURANCE, AND A CURRENTLY VALID MAJOR CREDIT CARD TO BE COPIED FOR THE RECORD AT THE FIRST MEETING. THE FEE AT THE FIRST MEETING MUST BE PAID VIA CREDIT CARD UNLESS AN ALTERNATIVE PAYMENT METHOD IS ARRANGED IN ADVANCE OF THAT VISIT. Employee Assistance Plan visits are the exception, no fee is collected from the client for those.
 
IF YOU HAVE QUESTIONS REGARDING THE ABOVE OR ANYTHING IN THE FORMS, CALL THE OFFICE AT LEAST 24 HOURS AHEAD OF YOUR FIRST VISIT SO THAT THEY MAY BE ANSWERED.