Counseling at White Lotus Wellness Center

Mindful Counseling, Cultivating Awareness

Welcome! Thank you for choosing to begin therapy with us. Appointments can be scheduled by phone or email. Below you will find information regarding expectations and policies. Your counselor will be happy to answer any questions you may have regarding this information.

NEW CLIENT FORMS

Please complete the following forms below. Separate forms for each individual are needed for families and couples. All forms and information provided will be kept confidential.

Informed Consent and Services Information Form

Provides information on services, policies, and includes acceptance of treatment and services policies.

Download FormInformed Consent and Services Information Form

Client Information & Wellness Assessment

Comprehensive questionnaire that collects important information related to treatment. If you find any of the questions uncomfortable to answer, you may leave it blank or write, “not ready to share” to let your counselor know.

Download FormClient Information & Wellness Assessment

Confidential Communications Request Form

Consent form for how you would like White Lotus Wellness Center to communicate Protected Health Information with you. Please indicate any communication restrictions you have on this form.

Download FormConfidential Communications Request Form

Notice of HIPAA Policy and Practices

This document outlines important information about the privacy and confidentiality of your Protected Health Information. Please read it carefully and sign the form to acknowledge that you have read and understood.

Download FormNotice of HIPAA Policy and Practices

Authorization to Release/Obtain Information Consent Form (Optional)

Complete this form to authorize your counselor to either obtain or release relevant information to another person or facility if needed.

Download FormAuthorization to Release/Obtain Information Consent Form

PREPARING FOR YOUR FIRST APPOINTMENT

Please arrive to your appointment on time because your appointment will not be extended even if you are late. The first 15 minutes or so may be used to fill out New Client Forms, if you have not completed them in advance.

The first appointment is about answering any questions you may have and learning about each other. The counselor may tell you a little bit about themselves, their professional interests, and explain to you what therapy is. They will ask about how they can help or why you have come. Please bring any notes if it is easier to remember. Objectives, goals, and expectations will be discussed.

White Lotus Wellness Center is committed to providing a safe and comfortable place. If you feel uncomfortable in any way, please tell your counselor. You are not obligated to answer any questions that you are uncomfortable with. Reflecting on your first appointment may be very helpful. Consider how you would like to proceed. Our counselors are happy to provide a referral to a specialist or discuss any concerns you may be experiencing.

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