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Serving Clients in Marshfield and Stevens Point, Wisconsin
Adult Informed Consent
Adult Cover Sheet
Adult Data Sheet
Adult Privacy Practices
Child Informed Consent
Child Cover Sheet
Child Data Sheet
Child Privacy Practices
Paperwork

Please download the relevant paperwork for your appointment with Steve:  
 
 - Age 18 and over: use the adult paperwork

 - Age 17 and under: use the child paperwork



Be sure to bring your insurance card with, too, so that Steve can have a copy of it in your file.  Also, it can be helpful for you to call your insurance company to verify your own benefits, coverage, and mental health eligibility.  Use the customer service number on the back of your card and tell them that you would like to see "Steve Johnson, Licensed Professional Counselor at Hergert and Associates in Marshfield or Stevens Point, Wisconsin".  With this information, they will be able to confirm if you need prior authorization, or not.  Feel free to call Steve if you have any questions at all.


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- Copyright 2011 - Steven L Johnson, Licensed Professional Counselor