• Counseling Appointment Request Form

    Isabel Vee Counseling

  • Please fill out the form below to request an appointment.

    Please note: This form is intentionally detailed so that important information can be gathered upfront before scheduling. Since my therapy services are specialized and I often have a wait list, your responses help me determine availability, clinical fit, scheduling needs, and the most appropriate next step. This helps make the appointment request process smoother while also giving you a better sense of my in-depth approach before moving forward.

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  • Date of Birth*
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  • Requested Services

    You can select more than one service.

  • **Please note we primarily provide Individual Counseling for Adults (18 yo+). However, we may be able to accomodate ages 16+

  • What Type of Service are you seeking?*

  • How do you plan on paying for services?

  • If using EAP Benefits, please indicate which company (SKIP if not using EAP):

  • Insurance Information

  • To expedite scheduling, please provide the following information.

     

    If you have medical insurance, it is important that you provide the information below. By doing this, the referral process is moved along more quickly.

    **You agree that by providing your insurance information, you are granting Isabel Vee Counseling the right to verify your insurance information in order to determine your coverage, co-pays, and/or deductibles.

  • Who is the Primary Policy Holder (person insurance is under)?*

  • Insurance Provider (If applicable).*

    • If you cannot provide at this time, or don't have your insurance information available, please enter NA

  • If you are NOT the primary policy holder, please enter the primary insured's information below:

  • Primary Insured's Date of Birth
     - -

  • Upload a photo of the front and back of your insurance card, if applicable. 

    Uploading your card is optional. However, if you plan to use insurance, it helps provide the information needed to verify your benefits and process billing accurately.

  • Upload Files
    Cancelof

  • Pre-screening

  • Crisis Notice: This appointment request form is not monitored for emergencies, and my services are not appropriate for mental health crisis or immediate care.

    Because it may take several weeks to begin services, please do not wait for a response to this form if you are currently in crisis, experiencing thoughts of harming yourself or someone else, or feel unable to stay safe.

    If you are in immediate danger, call 911 or go to the nearest emergency room. For 24/7 crisis support, call or text 988 to reach the 988 Suicide & Crisis Lifeline, or text HOME to 741741 to reach the Crisis Text Line.

  • Getting Started: Consultation, Intake & Scheduling

  • Consultation vs. Intake Appointment

    Consultation: is a brief call to help determine whether my services, availability, and therapeutic approach may be a good fit for your needs. This is often the best first step if you are still deciding between therapists or have questions before beginning services.

    Intake/First Appointment: The first full therapy session, which takes place after consent forms and required intake paperwork have been completed.This appointment involves a more detailed clinical assessment, including your concerns, symptoms, history, goals for therapy, and other information needed to determine an appropriate treatment plan. Because an intake appointment is more in-depth and begins the therapy process, it is generally intended for individuals who are ready to begin therapy services with Isabel.

    In summary: A consultation is a brief call to determine general fit before beginning services. An intake/first appointment is a full therapy session that begins the therapy process. If you are still deciding between therapists, a consultation is usually the best first step.

  • 1). Would you like to schedule a free 15-minute consultation before moving forward with a counseling appointment? Please select your preference below.

    • Free consultations are typically completed by phone, but video consultations are also available upon request. Free consultations are NOT completed in-person at this time. 
  • Phone Consultation Preference*

  • 2). Are you currently deciding between multiple therapists or providers before choosing who you would like to work with?

  • *

  • 3). Once therapy services begin, what is your preferred format for sessions?

    *Please note that in-person sessions are currently limited to 2–3 days per week and are generally available in the afternoons after 1:30 PM. Telehealth offers much more flexibility and availability, and may provide more scheduling options.

  • *

  • Specific Day and Time (if applicable):

    If you have a specific day and time preference, please provide the details below:

    Day:
    Time:

    Note: We strive to accommodate all scheduling preferences to the best of our ability. By providing specific days and times, we can better tailor our availability to meet your needs.

  • 5). For follow-up on your counseling request, how would you like the office to reach out to you?:*

  • By submitting this form, you acknowledge and accept the risks of communicating your health information via this unencrypted email and electronic messaging and wish to continue despite those risks. By clicking "Yes, I want to submit this form" you agree to hold Isabel Vee Counseling harmless for unauthorized use, disclosure, or access of your protected health information sent via this electronic means.

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