Patient Forms

Your Story Counseling Services, LLC uses TherapyPortal.com online to make filling out needed intake forms easier. Please call the office if you need your password reset to take advantage of this procedure.

* If you are unable to use TherapyPortal, you can print out one of the the appropriate packets below. Included are both PDF and DOCX (Word) files for your convenience. This packet contains the same forms you would see on the Portal. 

* If you need to fill out forms in person at the office, please come 20 minutes early to your appointment in order to have enough time. 

* Do I have behavioral/mental health coverage? 

* How many outpatient psychotherapy sessions am I allotted in my plan? 

* Are there any limitations, requirements, or restrictions in accessing my plan?

Additional Questions:

* Do I need a referral from my Primary Care Physician? 

* Do I need to have pre-authorization from my insurance company? 

* Is my therapist in your network? If not, what are my out-of-network benefits? 

* Am I authorized to see only a particular kind of therapist? (psychiatrist, psychologist, licensed mental health counselor)? 

* What is the effective date of my insurance coverage? 

* What is the amount of my deductible, co-pay, and co-insurance amounts after insurance adjustment is applied?