Welcome to 2023. It is almost unbelievable that this year is coming to a close and we are ushering in a New Calendar Year!! I hope that this New Year brings new opportunities and hope for you and yours. If you have a chance please stop by our Naperville Office and get a calendar so you can keep all of your appointments in a organized fashion. There are a few items that I would like to inform you of as you complete this packet.
1. In an effort to check your benefits in a timely fashion please complete the required information with all the requested aspects listed below. This makes it easier to know what is covered and it allows us to have the most up to date information available from your insurance vendor.
2. Your legal name is required on all of the forms. We are aware that you may identify with another name or moniker, however the purpose of these forms is to check benefits and have an accurate accounting of who you are legally. Pease feel free to talk to your clinician if you choose to be called by something different during sessions, however our front desk staff will be using your legal name on all correspondence, and to identify you in our systems.
3. Please be aware that our policy is that all payments are due the day of service. We are requiring that payments are made same day if you require arrangements please request those prior to your day of service.
4. We have a 48 hour cancelation policy, please remember to call prior to 48 hours to cancel an appointment as a missed appointment/late cancelation fee may be applied.
5. We are requiring that if you are a minor/dependent that needs assistance from a parent/guardian/helper during your sessions, please make sure that that person is available at the start of your session so that any needs or concerns can be addressed. There is a Release of Information included in this packet please complete that for any parties that need to have access to clinical. financial, or any other appointment information. If you are an adult and want others involved in your treatment a Release of Information is required, they may also be asked to complete intake information.
6. Please note that if at any point we have not been provided with the appropriate information to bill your third party then you may be responsible for your bill.
To save time please download and complete the forms below prior to your appointment:
Client Insurance Update Form:
CLIENT INSURANCE UPDATE FORM – 2018
ADULT INTAKE PACKET
Child/Adolescent Information Form:
Adolescent Intake Packet
Missed Appointment Policy
- Please Call or Text the Office at 630 428 2344 TO GET THE PROCESS STARTED
- THE FRONT DESK STAFF WILL BEGIN BY REQUESTING SOME DEMOGRAPHIC INFORMATION FROM YOU.
- YOU WILL THEN RECEIVE A PACKET FROM INTAKEQ WITH REQUESTED DOCUMENTS
- PLEASE COMPLETE AN INTAKE PACKET WHICH INCLUDES DEMOGRAPHIC ITEMS AND OTHER INFORMATION AS WELL.
- PLEASE UPLOAD ALL REQUESTED DOCUMENTS LISTED IN THE INTAKE PACKET.
- PLEASE NOTE THAT THE INFORMATION IS REQUIRED TO SECURE BILLING INFORMATION AND TO PLACE YOU WITH THE BEST THERAPIST.
- WE ARE REQUESTING THAT THIS INFORMATION IS COMPLETED IN 48 HOURS.
- IF YOU ARE USING A THIRD PARTY PAYER INCLUDING INSURANCE, EMPLOYEE ASSISTANCE, OR ANY OTHER THIRD PARTY, THE INFORMATION IS NEEDED PRIOR TO THE APPOINTMENT.
- PLEASE COMPLETE THE BOX TO THE RIGHT, TEXT, OR CALL THE OFFICE TO LET US KNOW THAT YOU HAVE COMPLETED THE INTAKE INFORMATION
- PLEASE SCHEDULE YOUR INTAKE SESSION.
- NOTE YOU MUST HAVE AN INTAKE SESSION PRIOR TO STARTING THERAPY.
- YOUR INTAKE SESSION MAY BE WITH OUR INTAKE SPECIALIST THAT IS A QUALIFIED PROFESSIONAL. BUT MAY NOT BE YOUR OMGOING THERAPIST.
- INTAKE SESSIONS ARE 45-55 MINUTES.
- IF A PERSON UNDER 18 IS BEING SEEN, PARENTS ARE REQUESTED TO BE AVAILABLE TO PARTICIPATE IN THE INTAKE.
- PLEASE SCHEDULE THERAPY APPOINTMENTS REGULARLY.