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    Counseling Intake Packets

    lifeinbalancecenter@gmail.com | 540-381-6215

    In compliance with the "NO SURPRISES ACT"
    We provide a "Good Faith Estimate" to all clients who do not have insurance or for those who choose not to use your insurance.
    Please contact our office for more information.
  • Life in Balance Counseling & Wellness Center

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    Client Forms

    Inside Wellness utilizes Simple Practice for all paperwork & payment. Once you schedule an appointment with the therapist, they will email you a secure link for you to input your information. It will take you about 15-30 minutes to put in your demographics, background basics, and payment/billing information. The only thing not included in this process is the Authorization for Release of Information, which is listed below. If you’d like your therapist to be able to talk with another provider such as a doctor, dietician, or prior therapist, then you’ll need to print & sign this document and bring it to the session with you.

    Adult Intake Form

    Child Intake Form

    If you need to collaborate your sessions with another advisor, you can fill out the next form. Once you do so, we can work together to make arrangements for the collaboration.

    Authorization for Release of Information

     

    Life in Balance Counseling & Wellness Center

    400 Roanoke Street

    Christiansburg Virginia 24073

    lifeinbalancecenter@gmail.com

    540-381-6215

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