FILES & FORMS

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SELF REFERRAL FORM

Please fill this out and email to Iowa Family Counseling prior to your first visit.

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.

PROVIDER REFERRAL FORM

Please fill this out and fax or email to Iowa Family Counseling to refer a client for services.

TELE-THERAPY INFORMED CONSENT

This document describes your risks and benefits to tele-therapy.  Please review carefully prior to your first tele-therapy visit.

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.

Questions?  Contact us!

P: 641-777-2774

F: 319-333-6098

©2019 by Iowa Family Counseling LLC