New Client Forms

I ask all new clients to read the Notice and Agreement, and sign the Signature Page. Submit the signature form to me by the end of the first meeting.

Print and fill out the Client Information Form and bring it to our first meeting. If we have talked on the phone to set up the first meeting I will have collected much of this information.

Health Insurance Forms

If you are planning to use Insurance to offset all or a portion of the fee, please fill out the top portion of the Health Insurance Claim form and submit to me.

Julie Gerut Oak Park Therapist

Please note that you need the free Adobe Acrobat Reader in order to open the forms. If you do not have it, you may download it here.

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