Policies and Procedures

Closing, Reviewing, and Reopening Clinical Case Records
No Show and Late Cancellation
Billing for Third Party Reimbursements
Procedure for Assigning Client Counseling Fees and Application of Subsidized Fee Schedule

English Counseling Forms

Accounting of Disclosures Log
Counseling Invoice
Determination of Subsidized / Amended Counseling Fee
Authorization, Appointments, and Fees
Individual Request for Protected Health Information
Individual’s Request for Amendment of Protected Health Information
Request for Alternative Means or Location of Confidential Communications
Request for Accounting of Disclosures
Authorization for Use and Disclosure of Protected Information
Treatment Authorization
Payment Authorization

English Counseling Instruments

Locke Wallace Marital Adjustment Test
DASS Severity Rating
Locke Wallace Test Scoring Key
Pediatric Symptom Checklist 17

Spanish Counseling Forms

Autorizacion, Citas, y Tarifas
Peticion Individual de Enmendar la Informacion de Salud Protegida por ley (Protected Health Information [PHI])
Peticion Individual por Informacion de Salud Protegida por ley (Protected Health Inforamtion [PHI])
Peticion por Modo Alternativo de Comunicacion Confidencial
Peticion por un Record del Compartimiento de Informacion Personal
Autorización de Seguros
Payment Authorization SPANISH

Spanish Counseling Instruments

Español DASS 21
Locke Wallace Prueba de Compatibilidad Matrimonial
Lista de Sintomas Pediatricos 17