Intake Forms

Registration and Billing
Absolutely everyone who is using insurance, or paying with cash, needs to fill out the Ardent Counseling Center (ACC) registration packet. Bring the ACC registration packet forms to your first session, (or preferably) email them to your therapist prior to your first session. Also, make sure that you called ahead to register

Clinical Intake Forms
Choose the form, or forms most appropriate to your situation and either email them to your therapist ahead of time (preferably) or bring them to your first session

Medicaid Intake Forms
Currently, Medicaid is available only in Iowa, but very soon will be available in Illinois as well. Choose the appropriate form, or forms, for yourself as an adult, or for your child and bring them to the first session, or (preferably) email them to your therapist before your first session

Release Of Information Form
Use this form if you want your therapist to be able to talk to anyone other than yourself, a doctor, partner, family member, etc. Most people should fill out this form ahead of time because very often we find that communication with others is vital to your case

Make an appointment today by calling us on (888) 870-1775 or by filling out our Contact Form