SERVING ALL OF CENTRAL WISCONSIN ― TO HELP YOU FIND WHAT’S MISSING


Please download and complete the following paperwork for your initial counseling session.  You have a choice between either downloading a PDF to complete by hand or a “fill-able form” that you can type into, save to your computer, and then either print yourself or use for emailing to APS (if that is your preference).

Adobe PDF’s to download and print:

If you are age 18 and over, please complete the (1) Adult Cover Sheet, (2) Adult Data Sheet, (3) Informed Consent,  (4) Notice of Privacy Practices, and (5) Email Consent.  You can also download this optional credit card authorization form, if we will be billing your insurance company.

If you are completing paperwork for your child or teenager (age 17 and below) or younger child, please complete the (1) Child Cover Sheet, (2) Child Data Sheet, (3) Informed Consent, (4) Notice of Privacy Practices, and (5) Email Consent.  You can also download this optional credit card authorization form, if we will be billing your insurance company.

Fill-able Forms to download and complete:

(Although our addresses have changed from what is listed on these forms, the forms themselves will still be acceptable.)

If you are age 18 and over, please complete the (1) Adult Cover and Data Sheet , (2) Informed Consent,  (3) Notice of Privacy Practices, (4) Email Consent, and (5) Signature Page.  You can also download this optional credit card authorization form, if we will be billing your insurance company.

If you are completing paperwork for your child or teenager (age 17 and below) or younger child, please complete the (1) Child Cover and Data Sheet , (2) Informed Consent, (3) Notice of Privacy Practices, (4) Email Consent, and (5) Signature Page.  You can also download this optional credit card authorization form, if we will be billing your insurance company.

Also, be sure to bring your insurance card with, too, so that a copy can be made of it for your file.  It is a our recommendation for you to call your insurance company to verify your own benefits, coverage, and mental health eligibility.  Use the customer service number on the back of your card and tell them that you would like to see a therapist at Advocate Psychotherapy Services in Stevens Point, Wisconsin.  Then give the name of the therapist you desire to see to check if he or she is in your network.  With this information, they will be able to confirm if you need prior authorization, or not, and tell you if services can be covered.  Feel free to call APS if you have any questions at all.