New Patient Forms

Your First appointment

Please complete new patient forms provided below within 24 hours of requesting a new patient appointment. It is required to complete a credit card form if you have a commercial (private insurance) OR if you are self-pay to be sent directly to you from our EHR system (SimplePractice/Client Portal Road to Ready Counseling). If you need of assistance completing the forms below, please contact us at admin@roadtoreadycounseling.com

Completing the intake forms:

There are two options for completing the intake forms for new patients:

1- You can email the forms provided below along with a copy of the FRONT and BACK of your insurance card(s) to admin@roadtoreadycounseling.com within 24 hours of scheduling your first appointment. If you have a commercial (private) insurance or are self-pay, you will also be required to complete a credit card form to be sent directly to you from our EHR System (SimplePractice/Client portal Road to Ready Counseling).

2- You can request for intake forms to be emailed directly to you from our EHR system (SimplePractice/Client portal Road to Ready Counseling) by sending an email to admin@roadtoreadycounseling.com with the following information: patient's first name, patient's last name, parent/legal guardian name (f the patient is a minor), and phone number.