Adam J. Vellturo Counseling Services
*Offering Telehealth Remote Counseling Services Throughout Arizone
*Offering Telehealth Remote Counseling Services Throughout Arizone
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Client Forms
Below you will find PDF files of forms that need to be reviewed and filled out prior to our first meeting. The Patient Service Agreement and The Notice of Private Practice , need to be reviewed in their entirety on your device. The Client Information , The Consent to Treat/Disclose , and The Informed Consent for Telehealth Services forms need to be printed, filled out and signed. These forms along along with your Insurance Card (if applicable) need to be scanned and emailed to [email protected] |
| Patient Service Agreement |
| Notice Of Privacy Practices |
| Client Information |
| Consent to Treat:Disclose |
| Informed Consent for Telehealth Services |
