Out-of-pocket clients have the right to receive a “Good Faith Estimate” explaining how much their healthcare will cost.

This form explains how Heart & Mind Counseling Services protects your personal information and safeguards your confidentiality.

Complete our Life Coach Client Intake Form to set clear goals and start your personalized journey toward growth, balance, and success with our certified life coach, Chris Dietz.

This form outlines what you can expect from therapy and ensures that you fully understand and agree to participate in counseling. It covers important information such as confidentiality and your rights as a client. 

With this form, you can create a personalized mental health safety plan with your therapist to stay supported, prepared, and safe during emotional distress.

Easily request your medical records online with our secure Medical Records Request Form. Access your men health information safely, quickly, and confidentially while ensuring HIPAA compliance.