Bellingham Family Counseling, PLLC
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  • Home
  • Consultation
  • Services
    • Couples Counseling
    • Anxiety and Depression
    • Grief Counseling
    • Trauma
    • Christian Counseling
  • FAQ
  • Scheduling and Fees
    • Fees
    • Insurance
  • About Me
  • Contact Me
  • Location
  • Resources
  • COVID-19 Policy
  • Contact Me
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YOUR CART

Welcome to Bellingham Family Counseling

Forms to Complete

Intake Forms
Your initial intake form will be available in the Jituzu client portal after you are sent an invite to the portal and set up your user identification and password.
Professional Disclosure and Notice of Privacy Practices
These documents summarize my training, credentials, and cancellation policies.  It reviews the limits of confidentiality and provide details regarding your privacy rights in keeping with the Health Insurance Portability and Accountability Act.  These documents will need to be printed and signed before the start of our first session.  You can scan the signed documents and upload them into your Jituzu client portal, or bring them to your first session.
                        ​  Print and sign                  
npp_and_disclosure_22.03.24.docx
File Size: 29 kb
File Type: docx
Download File


​Sliding Scale Fee Schedule and Application  

​Forms to Reference

sliding_scale_-_copy.docx
File Size: 21 kb
File Type: docx
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safety_and_care_plan.docx
File Size: 17 kb
File Type: docx
Download File

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