
P: 641-777-2774

FILES & FORMS
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INFORMED CONSENT FOR THERAPY SERVICES
The purpose of this document is to inform you, the client and/or guardian, about the many aspects of mental health counseling. This consent will provide a clear framework for your work together.
NOTICE OF PRIVACY PRACTICES
This notice describes how medical information about you may be used and disclosed, and how you can get access to this information. Please review it carefully.
CLIENT RIGHTS & RESPONSIBILITIES
This document describes your rights and responsibilities as a client of Iowa Family Counseling. Please review this information and let us know if you have any questions.
NEW CLENT REFERRAL FORM
Please fill out this form and fax or email to Iowa Family Counseling to refer a client for services.
Fax: 319-333-6098
INFORMATION ON GETTING STARTED WITH
TELE-THERAPY
This guide includes basic tips and instructions for how to join a video session as well as some FAQs to make your tele-therapy sessions successful.
COVID-19 OFFICE PRECAUTIONS
Prior to your appointment, please review our current COVID-19 precautions and your responsibilities as a patient by following the link below.
COVID-19 INFORMED CONSENT ACKNOWLEDGEMENT & AGREEMENT
This document acknowledges that you have received and understand Iowa Family Counseling's COVID-19 precautions, as well as your rights, and responsibilities as a patient. Please sign and return the last page.