Thank you for choosing North Star Counseling Services for psychotherapy. Please print, read, and complete all forms. Once completed, please protect your privacy by keeping the forms in a safe place. Bring the completed forms to your initial session.

Credit or debit card information (form below) is required to cover any deductibles, copayments, or coinsurances. Once your benefits & eligibility information is determined with your insurance provider, payment is typically processed within 24 hours of each session.

Information & Insurance

Health History

Consent & Financial Agreement

Credit Card Authorization