New Patients

Hendrick Counseling Welcomes You!

New Patient Information

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. Please Note:  “Fillable” can be completed and emailed to our office.

Adult Counseling Form
Child/Adolescent Counseling Form
Patient Medication Management Form
Anger Management Protocol

Fillable Forms:
Adult Counseling Form (Fillable)
Child/Adolescent Counseling Form (Fillable)
Patient Medication Management Form (Fillable)

These are downloadable in .pdf (Adobe Acrobat Reader) format. Please visit to download Acrobat Reader, if necessary. Click on form to open, download and print or complete.

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.

  • 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
  • If you are sending your minor child in independently for a session, please ensure that he/she has the appropriate payment required
  • Office weather 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.
  • If you are in need of a medication refill, please have your pharmacy fax your request to 615-453-7051 and allow two business days for processing.

* Do not bring children to adult sessions

We currently participate with Insurance Companies, INCLUDING but not limited to:
However, please note that not ALL of our providers are in-network with each and every insurance company. If you have further questions regarding coverage, please call the office at 615-449-9611
  1. Blue Cross Blue Shield
  2. United Health Care
  3. United Behavioral Health
  4. Meritan
  5. Magellan
*We are NOT in-network with any of the TN Care Plans as a primary insurance.
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  1. Medicare
  2. Cigna
  3. Beacon Health
  4. Aetna
  5. Medicare Advantage Plans
Hendrick Counseling Services

Listening Because We Care

Information presented at 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.
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