Adam J. Vellturo Counseling Services
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Client Forms
Below you will find PDF files of forms that need to be reviewed and filled out and brought to our first meeting. The Client Service Agreement and The Arizona Notice of Private Practice need to be reviewed in their entirety on your device. The Client Information and The Consent to Treat need to be printed, filled out, signed and brought to our first meeting along with your Medical Insurance Card. If we will be conducting our sessions by video/phone chat then the Informed Consent Telehealth Services form needs to be printed and filled out and signed as part of the intial session. This form along with the other forms and insurance card will need to be scanned and emailed to avcounseling1@gmail.com |
Client Service Agreement | |
File Size: | 108 kb |
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Arizona Notice of Private Practice | |
File Size: | 83 kb |
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Client Information | |
File Size: | 73 kb |
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Consent to Treat | |
File Size: | 61 kb |
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Informed Consent for Telehealth Services | |
File Size: | 51 kb |
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