Client Paperwork & Forms

Complete Forms Online

Below are links to our secure and HIPAA compliant online forms.  For your convenience, you can complete forms securely through the link to the JotForm.com form site.  You are not under any obligation to use the online version and can instead opt to download the PDF version via the link provided.

All forms completed and submitted to PeoplePsych through the online forms are downloaded securely and are not saved on the provider server.

Clicking the thumbnail image will take you to an external website for online form completion and submission.

New Client Forms

There are a few forms that we need every client to complete.

Please submit the completed forms to PeoplePsych prior to your appointment - if you are not using the online format, please fax or email the form directly to your therapist. If you forget to this prior to the appointment, your therapist will simply have you complete the forms prior to starting your session, so no worries!

Also, if you wish to use insurance, please take a picture of the front and back of your insurance card as we like to have a copy on file. Our billing service will call and verify your benefits after the initial session.

Changing Your Information

If the event that you need to update your address, insurance information or credit card we ask that you complete the needed form below - and give to your therapist - for our records as soon as possible.

And if your insurance is new, please also bring your new insurance card, along with the completed form, so that we can maintain a copy for our records.

Release of Information (ROI)

In the event you wish to enable anyone to communicate with your therapist or other PeoplePsych personnel - for clinical or financial reasons - a completed Release of Information (ROI) is required prior to all communication.

COVID-19  In-Person Waiver

Due to the coronavirus global health pandemic, all clients being seen in-office need to complete our Informed Consent for In-Person Sessions. In the event that a client does not wish to comply with the health and safety precautions we have established, they can request to meet via telehealth and will not be permitted to resume in-office sessions.



111 N Wabash Ave #1203
Chicago, IL 60602

53 W Jackson Blvd., Suite 1605
Chicago, Illinois 60604

admin@peoplepsych.com
312-448-7218

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