Filling out the forms below is as Easy as 1-2-3…

FORM ONE

FORM TWO

This form is used to collect basic information about you and your insurance provider. 

FORM THREE

This form is an in-depth intake document that needs to be completed prior to our first session.

Very Important Form! This form reviews your basic rights and policies and procedures of Deirdre Haynes Counseling Services.

FORM FOUR

This form reviews other important rights that you have as a client of Deirdre Haynes Counseling Services.

FORM FIVE

This forms lists some of the fees associated with Deirdre Haynes Counseling Services. Your insurance provider or EAP may pay all or some of these fees.

FORM SIX

This form describes how medical information about you may be used and disclosed. Please review carefully.

FORM SEVEN

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