Please ensure all forms are completed prior to your appointment. We ask that you email your insurance inquiry form and copies of insurance card to the billing department located at the bottom of insurance inquiry form. All other forms should be emailed to ghowelllpc@healthworkscounseling.com
Please allow at least (4) business days for insurance verification. We ask that you submit forms at the time of appointment scheduling by downloading the forms below.
I accept some insurance plans and private pay.
It is the client responsibility to contact insurance and determine if prior authorization is required, as well as coverage and benefits. You,as the client, are responsible for any balance not covered by insurance.
Payments are due at the time of service.
Patient Forms
Client Demographics
Hipaa Consent
Initial Assessment Form
Insurance Inquiry
Patient Email Policy and Consent
Informed Consent and Description of Services
Telehealth Consent
