Forms
Here the form that you will need for your counseling.  You can either fill out the form online and print it.  What you fill in cannot be saved or sent, but can be printed out. 

COUNSELING FORM

Counseling Form (PDF) (fill-in-and-print)  The first two pages are client agreement, but then fill in the rest of the pages on your computer. 

This form contains:

• Counseling Agreement

• Client Information

• HIPPA form

• Directions to the office

Counseling Form (Print-able then fill in by hand) If you are having trouble filling it on online, print this one and then fill in by hand.

INSURANCE FORM

Erik Bohlin, M.A. is a preferred provider with Blue Cross, Blue Shield and the Uniform Medical Plan of Washington State. 

If you have insurance with one of these plans, you will want to print out the Insurance form.

Insurance Form (fill-in-and-print)

or

 Insurance Form (print and fill in by hand)

If you want me to check your insurance coverage, fax the insurance form to me at FAX no: 425-334-2427.  I can then follow up by calling either your insurance company or the provider you want me to speak with. there is also a fill-in-able form that is secure and encrypted for confidentiality through Starfield.

EXTRA INDIVIDUAL FORMS

You do not need to print these out if you printed out the above Counseling Form.  These are extra forms if you need them for any reason.  If you needed an extra form for marital counseling you will want to an extra "Counseling Agreement" and "Client Information" form.

Client Agreement  (in MS Word)

"Client Agreement" (in PDF)

This form describes my credentials, confidentiality and your rights as a client.  This form begins our counseling relationship and is signed at our first counseling session.

"Client Information" (in MS Word) 

"Client Information" (in PDF)  (This is fill-in-able)

This form helps you bring summarized information to your session.  It give me an idea of who you are and saves counseling time and cost when you fill it out.

"Insurance Information" (in MS Word)

"Insurance Information" (in PDF) (This is fill-in-able)

This form allows me to contact your insurance company regarding coverage.  You can sign it and fax it to me if you want.

"Disclosure Form to talk with other Professionals" (in MS Word) 

"Disclosure Form to talk with other Professionals" (in PDF)

This form, after signing it, allows me to talk with another professionals about your care.

"Notice of Privacy Policy" (in MS Word) 

"Notice of Privacy Policy" (in PDF)

This describes our privacy policies according to HIPPA

Directions to Erik Bohlin's Offices (In PDF) (in MSWord)