ClientForms
Everything you need to get started with therapy. View, complete, and submit the required forms securely at your convenience—whether you're a new client starting therapy or an existing client updating personal or medical information. This helps us prepare for your care and make the most of your session time.
Before Your First Appointment
We kindly ask that you please complete the forms that are labeled Required for All, along with any additional forms that apply to your specific situation.
These forms help us understand your needs, protect your privacy, and ensure a smooth start to your care. If you’re unsure which forms apply to you, our team is here to help.
Required forms must be completed at least 24 hours before your first appointment. Incomplete forms may result in cancellation.
- Client History Form - Required for all clients
- Client Contract & Consent for Treatment - Required for all clients
- Coordination of Care - Required for all clients; Used for communication with medical providers. If you do not have a provider for us to coordinate care with, please select "No" when prompted.
- Payment Authorization - Required for all non-Medicaid clients. This form is not available on our website. A separate email will be sent with your SLC client portal link and payment authorization form.
- Release of Information - Optional; Used for communication with contacts such as school staff, attorneys, probation officers, family members, etc.
- Shared Custody Consent & Financial Consent - Required only for divorced/separated/unmarried parents or legal guardians if a legal shared custody or financial agreement is in place.
Client History Form
All clients are required to complete the Client History Form at least 48 hours prior to their first appointment. This form collects important background and contact information to help our team prepare for your visit and ensure your care starts smoothly.
Please have your insurance card(s) and driver’s license/ID ready!
Client Contract & Consent for Treatment
The Client Contract & Consent for Treatment outlines our practice policies and helps set clear expectations for care at Silver Linings Counseling. It also documents your informed consent to participate in counseling and related services with our team.
This form covers important topics such as attendance and cancellation policies, fees and billing, communication guidelines, confidentiality and its limits, and your rights and responsibilities as a client.
By reviewing and signing this form, you acknowledge that you understand our policies and agree to participate in treatment with Silver Linings Counseling.
Coordination of Care
The Coordination of Care form allows you to authorize Silver Linings Counseling to communicate with your medical or prescribing providers who are involved in your care, such as psychiatrists, primary care physicians, or other healthcare professionals.
By completing this form, you give permission for our team to share and request relevant clinical information to support safe, coordinated, and effective treatment. You choose which providers we may contact and what information may be exchanged.
→ If you do not have a medical professional you’d like us to coordinate care with, please select “No” when prompted.
Payment Authorization
To protect your privacy and payment information, our Payment Authorization form is not located on our website. You will receive a welcome email with instructions to create your secure client portal, where this form can be completed.
Keeping a credit card on file helps us make the billing process smoother and more predictable for everyone. It allows us to apply copays, account balances, and missed appointment fees promptly and accurately, without delays or repeated follow-ups.
→ For clients who use an HSA card, we also request a backup card so charges can still be processed if HSA funds are temporarily unavailable. If your HSA is replenished on a regular schedule, letting us know the timing helps us avoid using the backup card when possible.
Shared Custody & Financial Consent
This form is only required if the cline is a minor, AND there is a legal custody agreement in place (typically in case of divorce).
Each parent must complete their own Shared Custody Consent form prior to their child’s first appointment. SLC may request a copy fo the legal custody agreement and any related financial agreements regarding healthcare.
If a financial agreement specifies that each parent is responsible for a percentage of healthcare costs, each parent will be required to have a valid credit card on file with SLC.
This form is NOT required if parents were never married, or one parent is not involved in the child’s life, and there is no legal custody order.
**Silver Linings Counseling does not mediate between divorced or separated parents. It is the responsibility of both parents to communicate directly with one another regarding scheduling, transportation, and financial responsibility for services. SLC staff will not serve as intermediaries or become involved in custody or financial disputes.
Both parents are equally responsible for informing SLC of any changes related to financial arrangements, availability for appointments, or concerns regarding the child’s treatment. Our focus remains solely on providing quality care for the child, and we do not take sides in family disagreements or legal matters.
Release of Information
If you would like to authorize Silver Linings Counseling to communicate with additional non-medical individuals or organizations at any time, please complete a new Release of Information form.
This form may be used to allow communication with individuals such as school staff (teachers, counselors, or administrators), probation officers, attorneys, family members (including parents, spouses, or adult children), or other designated contacts for care coordination, billing, or scheduling purposes.
For communication with medical or prescribing providers (such as psychiatrists, primary care physicians, or other healthcare professionals), please complete our Coordination of Care form instead.
Please Note:
A Release of Information is not required for SLC to use or disclose information in the following circumstances:
For billing and payment activities with your insurance company
When required by federal or state law (including mandated reporting of abuse or risk of harm to self or others)
For internal practice operations and care coordination
In response to a valid court order or subpoena
When necessary for treatment, payment, or healthcare operations, as permitted under HIPAA
We are committed to protecting your privacy. Information is shared only as allowed by law and in accordance with your preferences whenever applicable.
If you have any questions about which forms you need to complete, or how to submit them, please contact us.
Thank you for your cooperation — we look forward to working with you!