New Client Policy

Welcome. We are glad that you are considering Journey to Hope for your counseling needs.  It is our goal to provide you the very best we have to offer every single time you come through our doors.  Part of the process of signing up to become a client at Journey to Hope requires commitment on your part in making your first appointment and acknowledging our new client policy. We try very hard to work with you and to run an efficient private practice. Because our highest rate of no shows and cancellations without notice are our first time appointments, the following policy is in place regarding your first appointment.

Journey to Hope requires a valid credit card, personal check or cash to be held to secure your first time appointment. If you have to cancel your first appointment, we require a 24 hour notice in cancelling.  Should you choose NOT to call or to come to your first appointment, your credit card WILL be charged $150.00.  Your appointment has been set aside especially for you.  

If you arrive for your first appointment on time, you will only be charged your regular co-pay or fee for service counseling charge.

Please complete the following form and submit to acknowledge this policy regarding making your first appointment with Journey to Hope.  Once you submit  this acknowledgment, please call our office to make an appointment and give us your credit card information.  DO NOT send your credit card information over the internet. If there is no answer you may leave a message and someone will call you back.

Please complete the following and submit to acknowledge you understand this policy regarding making your first appointment with Journey to Hope. Thank you.

 

 

Name *
Name
Phone *
Phone
If you are in insurance client, please note your insurance provider below.
Acknowledgement *
Checking this box and submitting the form means you acknowledge the Journey to Hope Counseling 1st Appointment policy described below.
Date *
Date
Current Date