Intake forms

Intake Forms for Clients: 

Intake forms must be completed prior to your first appointment. You can access your intake forms in the client portal. Please use the button below to log into the client portal and complete your forms.

Ongoing Forms

Authorization to Use and Disclose Information: If you wish to grant permission to your provider to consult with or release information to an individual or entity outside of the group an AUD form needs to be completed in order to give proper consent to your counselor to release confidential information. Please contact our records department at records@radzomcounseling.com to request that an AUD form be sent to your client portal.

Autopay / Card on File Enrollment: To update your card on file (required for all clients). Click the button below to log into the client portal. After logging in navigate to the billing and payments page then add your new card to the payment methods tab.

Update Insurance Information: If your insurance changes and you need to update your insurance information please contact our administrative offices with your updated information.