Before Your Appointment
Please download, complete, and return all required forms before your first appointment. This helps us make the most of your session time.
How to return completed forms: Email your completed forms to [email protected] at least 24 hours before your scheduled appointment.
Required for all new counseling clients
Complete before your first therapy session. Includes personal information, presenting concerns, and mental health history.
Reviews your rights as a client, confidentiality limits, telehealth policies, and the therapeutic relationship.
Explains how your health information is used and protected in accordance with federal HIPAA regulations.
Acknowledges the nature of telehealth services, technology requirements, and emergency procedures.
Required for all DOT SAP evaluation clients
Required prior to your SAP evaluation. Includes employment information, violation details, and substance use history.
Authorizes Next Opportunity Counseling to communicate with your employer or DER regarding your return-to-duty status.
Outlines the SAP evaluation process, your rights, confidentiality limits under 49 CFR Part 40, and reporting obligations.
Required for clients returning for follow-up evaluations after completing the recommended education or treatment program.
Download all required forms for your service type
Complete forms fully — leave no fields blank
Email completed forms 24 hours in advance
Have your insurance or payment info ready
Test your video connection before your telehealth session