Forms and Policies

At the Counseling & Wellness Center, we make every effort to accommodate your unique situation. If you need assistance with any of our forms or policies, please reach out.

Payment for Services

Payment of deductibles, co-payments, co-insurance, and self-pay amounts are due at the time of service. As a courtesy to you, we will file your primary and secondary insurance.

 In divorce situations, the parent bringing the child to The Counseling & Wellness Center for care will be responsible for all charges during treatment.

 We will first send a letter requesting payment or call to discuss payment options for any unpaid balance. We reserve the right to use a collection agency. No clinical information is given to collection agencies.

Late Cancellation and No Show Fee

A $40 fee will be charged for appointments cancelled or missed with less than 24 hours notice. If you need to cancel an appointment, please call our office during business hours: Monday-Thursday 9 AM- 5 PM

Please Be On Time

Patients who are 10 minutes or later for appointments may be rescheduled. This decision will be made by the nursing staff. 

Additional Resources / Forms

Why Medical Screening?

Download our flyer: Why do I need medical screening (PDF)

Medical Screening for PCP

Download our flyer: Medical Screening for PCP (PDF)

Psychological Testing 

Download: Parent Report (PDF)

Download: Vanderbuilt Parent (PDF)

Download: Teacher Report (PDF)

Download: Vanderbuilt Teacher (PDF)