Creeksidecounselingks.com

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Mental Health Services

WebFor emergencies call 911 or visit your nearest hospital. (785) 648-5664. (785) 648-5665. P.O. Box 93, Mankato, KS 66956. saragrout@creeksidecounselingks.com. Our …

Actived: 4 days ago

URL: https://creeksidecounselingks.com/

THERAPY SERVICES Therapy can have benefits and risks. Risks …

WebI NFO R ME D CO NS E NT Welcome to Creekside Counseling, LLC. This documentcontains important information about the mental health services provided by …

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ACKNOWLEDGMENT OF RECEIPT, REVIEW, AND …

WebAssignment of Benefits.I hereby acknowledge I havereceived verbal explanation and have been providedthe opportunity to read a copy of Creekside Counseling,LLC’sInsurance …

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Rights and Responsibilities

WebCLIENT RIGHTS & RESPONSIBILITIES You have the right to services regardless of race,color, religion, age, sex, sexual orientation, national origin, or disability.

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requirements, I authorize Creekside Counseling, LLCat P.O.

WebAUTHORIZATION FOR THE USE AND DISCLOSURE OF PROTECTED HEALTH INFORMATION NAME OF INDIVIDUAL: Last First Middle Initial Date of Birth

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Notice of Privacy

WebUse and disclosure of your personal health information for marketing purposes, including subsidized treatment communications, will only be made with yourwritten authorization.

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Telehealth Informed Consent

WebTELEMENTAL HEALTH INFORMED CONSENT This form contains information about the telementalhealth services provided by Sara Grout, LMSW. Pleaseread it

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