Client Paperwork & Forms

New Client Forms

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

You can download them in PDF format here. Please bring the completed forms to your appointment and give them to your therapist. If you forget them, we will simply have you complete them when you arrive, so no worries!

Also, if you wish to use insurance, please bring your insurance card so that we can make a copy of it 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.

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

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