Please download and print the files on this page after scheduling your initial individual counseling appointment with your therapist. Please be sure to complete all of the forms, including signing the HIPAA form on the back page. Pay close attention to fill in all the starred blanks on the “No Surprise Billing form. Some of the required information on that form will be redundant but we are following federal regulations.
Even though your counselor is “not in network” with any insurance you may have, you may want to check with your insurance policy to see if they will cover your planned services. If they will cover them, then scan the front and back of your insurance card along with the front of your drivers license. Then you should include these images with your other forms when you submit them. Of course if you have no relevant insurance then just submit your registration forms alone.
Scan all your images into ONE continuous pdf file (Adobe Scan can do this easily). Submit your pdf file with the secure file transfer mechanism at the bottom of this page. Alternatively you can snail-mail the documents to our office:
Cary Counseling Center
875 Walnut Street Suite 275
Cary, NC 27511