Our Clients

Paperwork for New & Established Clients

Before Your First Appointment

Please take a few steps to ensure that your initial session goes smoothly.
If you are planning to use your insurance please review the Fees & Insurance section below to understand the process for using your insurance or how to use your out-of-network benefits.

Prior to your initial session you should also complete all of your paperwork and follow the instructions for filling out the forms. Please also bring your insurance card to the first session so that we have it on file and can call to confirm your benefits.

If you know the name of the counselor you would like to meet with contact that person directly. If you would like our intake coordinator to help you make a match based on style, availability or any other criteria, please leave a message in our intake voicemail box at 847-699-2490 x2 or send us an email via the form on our Contact page.

New Clients

All new clients of Glenview Counseling Group are required to fill out the following forms: Intake Forms, New Client Assessment and Telehealth Authorization. Additionally, new clients may also fill out the Release of Information form, which allows your therapist to communicate with any other providers or family members of your choosing.

You will not be able to meet with your counselor if these forms are not completed at least 2 business days before your first appointment.

  • Intake Forms

    This form gathers basic information needed to begin counseling as well as inform you about our policies and procedures. We ask that each new client also keep a credit card on file so that we can expedite billing services.

    Intake Forms

  • New Client Assessment

    This form helps your counselor understand your needs in counseling. Please complete this document before your first session. If you are seeing a marriage therapist please have each spouse or partner complete her or his own form.

    Assessment Form

  • Telehealth Authorization

    This form is for the purpose of informing you and asking your consent for the use of telehealth and other telecommunication formats.

    Telehealth Form

  • Release of Info Form

    This document allows us to communicate with others outside of our practice, such as family members, other providers, etc.

    ROI Form

Established Clients

The following page includes forms that are intended only for established clients of Glenview Counseling Group who need to update information in our system. If you are a new client of the practice please refer to the New Clients section above.

  • Additional/New Insurance

    This is an optional form. Please only fill out this form if you have more than one insurance plan and/or your insurance plan has changed since becoming a client of Glenview Counseling Group.

    Insurance Form

  • Additional/New Credit Card

    This is an optional form. Please only fill out this form if you have more than one credit card and/or your credit card has changed or expired since becoming a client of Glenview Counseling Group.

    Credit Card Form

  • Client Info Update

    This is an optional form. Please only fill out this form if you need to update information that has changed since becoming a client of Glenview Counseling Group, such as new home address, new phone, name change, etc.

    Info Update Form

  • Release of Info Form

    This document allows us to communicate with others outside of our practice, such as family members, other providers, etc.

    ROI Form

Fees & Insurance

  • Fees are set by our practice or by your insurance provider's contracted in-network rate. We believe that everyone should be able to afford counseling and so we offer a sliding scale fee in certain situations. For more information feel free to contact us.

    All of our providers are in-network for Blue Cross Blue Shield PPO and Blue Choice, as well as Aetna.

  • The best way to verify that your counselor is an in-network provider for your insurance plan is to simply call the customer service phone number on the back of your card. Let them know that you would like to begin counseling with one of our providers and they can verify your benefits and confirm that he or she is an in-network provider.

    You may also be able to utilize online provider lookup, if offered by your insurance carrier.

  • If our counselors are not considered in-network providers for your insurance plan we are happy to provide you with receipts for services to be submitted to your insurance carrier.

    If you have any questions regarding your insurance company's out-of-network benefits, simply call the customer service number on the back of your card. Payment for all out-of-network clients is due at the time of service.

  • Beginning on January 1, 2022 the federal No Surprises Act will go into effect.

    Part of this act stipulates that anyone who will not be using his or her insurance benefits, or does not have insurance benefits, is entitled to request a Good Faith Estimate, which outlines the estimated costs of counseling.

    To learn more about the No Surprises Act and the Good Faith Estimate please click here.

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