General

Client Services Agreement

Wake Kendall HIPPA Notice Form

New Client Documents

Checklist for New Clients

New Client Information Sheet

Consent to Electronic Communication

Payment Authorization Form for Therapy

Authorization Form

Agreement with Payors of Adult Clients

Child Therapy Agreement

Payment Authorization Form - Assessments

DBT

DBT Adult Application

Admissions Testing

Admissions Testing Registration Form

Other

WakeKendall EASE Application

Payment for Services

We are not within-network for any managed care companies, and we are not Medicare providers. If you choose to pursue reimbursement for out-of-network providers, please keep in mind that any reimbursement should be directed to you, as we do not accept checks from insurance companies.

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