Client
Forms

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 complete the relevant forms listed below. These forms help us better understand your needs, protect your privacy, and ensure a smooth start to your care. If you have any questions about which forms are required, our team is here to help.

Clients must complete their registration packet and payment authorization form at least 48 hours before their first appointment.
You will receive a separate email with the link to create a client portal and fill out your payment authorization form (please check your spam folder). A credit card on file is required for all non-Medicaid clients.
New Client Paperwork Packet (clickable link): Required for all new and returning clients.
Release of Information (clickable link): Optional form for authorizing communication with doctors, psychiatrists, schools, or other individuals.
Shared Custody Consent (clickable link): Required only for divorced, separated, or unmarried parents/legal guardians if a legal shared custody or financial agreement is in place.

Registration Packet

All clients are required to complete the Registration Packet at least 48 hours prior to their first appointment. This packet includes general registration information, practice policies, consent to treatment, and a release of information section (if applicable).

Please have your insurance card(s) and driver’s license/ID ready!

Payment Authorization Form

All clients are required to maintain a valid payment method on file with SLC. The required form for adding or updating a payment method is located in your secure client portal and is not available on our public website.

Credit Card Acknowledgement

Because our system only allows one payment authorization per client profile, you may use the Credit Card Acknowledgment form if:

You wish to use the same credit card for multiple children or multiple client accounts
You would like to add a backup credit card for your HSA

Important: If using this form, you must first contact SLC with the full credit card number. After providing your card information, you will then complete the Credit Card Acknowledgment form.

Shared Custody 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

Although the Registration Packet includes a basic Release of Information section, if you need to authorize SLC to communicate with additional individuals or organizations at any time, please complete another form.

You may use this form to allow communication with, Psychiatrists or prescribing physicians, Primary care doctors, School staff (teachers, school counselors, administrators), Probation officers, Lawyers, Family members (parents, spouse, adult children) or other designated individuals for billing or scheduling purposes.

Please Note: A Release of Information is not required for SLC to release client information under the following circumstances:

For billing purposes with your insurance company
As required by federal or state law (e.g. mandated reporting of abuse or danger to self/others)
For internal practice management purposes
In response to a valid court order or subpoena
When necessary for treatment, payment, or healthcare operations as permitted under HIPAA

If you have any questions about which forms you need to complete, or how to submit them, please contact us.