Child Mental Health Therapy - Intro/Registration Form
Dear New Family,

Welcome to New Horizons Wellness Services, LLC (NHWS)! We are excited to have the opportunity to assist your child in their mental health care. Our therapists strive to provide the highest quality of care in a professional and supportive manner.  We are committed to helping you identify your child’s needs and achieve their goals.  

Please read the information carefully and fill out all the requested documents. Once we receive your insurance information, we can verify your insurance benefits. Please remember that if your insurance information is not received before your child's appointment, you will be required to pay for the session in full at the time of the appointment.

It is important for you to understand that it is your responsibility to contact your insurance company regarding your benefits prior to the appointment. We do not bill secondary insurance. Please note that any deductibles, co-insurance, and/or copayments are due at the time of the appointment. We accept cash, checks, Visa, MasterCard, and Discover. Checks should be made payable to New Horizons Wellness Services. If you wish to pay by credit card, please have your driver's license and credit card with you at the time of your appointment.

It is our sincere desire to partner with you and your child as we start this new and exciting journey together.
 
With kind regards,

 
The Providers and Staff of New Horizons Wellness Services, LLC


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