New Client Enrollment
- Please complete the brief intake form to provide some basic demographic information about your child and family, the concerns you have and the services you are seeking, and your insurance information (if applicable). This form is confidential and is processed through a program called DocuSign. It will be sent to the intake coordinator who will then reach out to you for further information. You may also call the center at 412-741-4087 if you are unable to complete the form.
- Once an appointment or evaluation has been scheduled, you will be asked to fill out the client history form and LCC consent, communication & financial policy form below. The forms will open into a program called DocuSign which allows you to complete and submit the forms electronically. If you are unable to complete the forms electronically or would like to have the forms in a paper version, the forms may be mailed to you per your request.
The client history form is to provide a general background of your child and family, and your current concerns.
The LCC Consent is a form the parent(s) or guardian(s) signs in order to permit Laughlin to complete an evaluation and/or therapy.
The Communication Consent is to inform you about our policies around electronic communications. The Financial Policy Consent form details our policies around treatment and care related to insurance and payment for services.
The Credit Card Authorization form allows Laughlin to keep your credit card information on file to be charged for online services. If you have trouble filling out these online consent forms, please call 412.741.4087