440 Park Avenue
Lebanon, TN 37087
615-449-9611



 New Patients

Hendrick Counseling Welcomes You!

New patients, please print and complete the forms below to prior to your initial visit.  We prefer to have your forms completed prior to your arrival in our office to make your visit as efficient as possible.  A copy of the privacy notice can also be obtained at your visit if you wish to have a hard copy.

Authorization For Release
Confidentiality Policy
Consent to Treat
Insurance Company Info
Patient Information Sheet
Help Us Help You Sheet

These are downloadable in .pdf (Adobe Acrobat Reader) format. Please visit www.adobe.com to download Acrobat Reader, if necessary. Right-click and print.

For your convenience, we now accept Visa, MasterCard, HSA cards, and Debit Cards (Note: Payments made using these methods will incur a $3.00 processing fee)






PLEASE READ THESE IMPORTANT NOTES
*  PLEASE BRING AN UPDATED INSURANCE CARD TO YOUR OFFICE VISIT.
THIS IS ESSENTIAL TO FILE WITH YOUR INSURANCE COMPANY IN A TIMELY MANNER.

*  Cancel 24 hours in advance if unable to keep an appointment

*  Arrive 15 minutes early to complete necessary paperwork

*  Deductibles and co-pays are expected prior to the start of your session

*  We accept cash and personal checks only If you are sending your minor child in independently for a session, please ensure that he/she has the appropriate payment required.

*  Office snow policy: If the Lebanon City Schools/Lebanon Special School District is closed due to inclement weather, our office is also closed. If the school closure is on a Friday, our office will be closed that Saturday, as well.

*  Do not bring children to adult sessions  


Insurance Information

We currently participate with Insurance Companies, INCLUDING but not limited to:

1.  Blue Cross Blue Shield
2.   United Health Care
4.   United Behavioral Health
5.   Healthscope
6.   Magellan
5.   Medicare
6.   Cigna
7.   Phcs
8.   Aetna
9.   Compysch
10. Horizon Healthcare
11. Fiserv
12. Ceridian
13. Valueoptions
14. EAP Programs
15. Healthspring
 
If you have further questions regarding coverage, please call the office at 615-449-9611


"Listening because we care" 
© Copyright 2012 Hendrick Counseling All Rights Reserved. Information presented at HendrickCounseling.com is for educational purposes only and is not a substitute for medical or mental health advice or treatment for specific medical or psychological conditions. You should seek prompt medical care for any specific health issues, and consult your physician before starting a new health or fitness regimen. Use of this online service is subject to this disclaimer and the terms and conditions. Please read our PRIVACY STATEMENT.