Commonly Used Forms
Below are our most common forms. Don’t see what you’re looking for? Contact email@example.com and we will gladly assist you.
TELEHEALTH DISCLOSURE, please complete and email to either your clinician or firstname.lastname@example.org
LEVEL B GROUP SCHEDULE, for virtual groups.
NIC WELCOME PACKET, used for all first-time appointments and for clients who have gone more than 6 months since their last appointment.
RE-ENROLLMENT PACKET, for clients returning to NIC after 30 days to 6 months without services.
SLIDING SCALE APPLICATION, application to lower the cost of on-going treatment. Does not apply for intakes or evaluations.