Still Waters Counseling

Effective Help from Caring, Experienced Professionals

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Forms can be printed, filled out, and brought to your first appointment.  

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Assignment of Insurance Benefits

Billing Information Form

Confidentiality of SA Records

Consent for Treatment

DHS-Court Consent

Fee Agreement

HIPAA Signature Form

Initial Contact Information Sheet - Adults

Initial Contact Information Sheet - Children

Mailing List Form

Payment Plan Form (for established clients)

Notice of Privacy Practices

Release of Information

Release of Information for Substance Abuse Services