New Client

Welcome to the new client page. Please fill out the New Client Intake Form. Once we have your information we can verify your insurance coverage and advise if you may need a referral or authorization. Please know that while we can assist you with your health insurance, it is your responsibility to know your plan requirements, coverage and payment of all fees. If you are not using health insurance please leave that section blank.

NEW CLIENT INFORMATION:


** E-mail is not always confidential. If you prefer, you call us or fax the information. **

Questions?

If you have questions feel free to e-mail or call us.
Norman Dasenbrook, LCPC
norm@dasenbrookandjohnson.com
815.877.0399
Fax. 815.877.9382
Nadia Johnson, LCPC
nadia@dasenbrookandjohnson.com
815.282.2462
Fax 815.877.9382

Before your Appointment

Please download the HIPPA and Informed Consent Documents, sign them and bring them to the initial appointment.

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