Axiomcounseling.com

Professional Therapists & Counselors in Wichita, Kansas Axiom …

WEBReach true wellness and live life to the fullest! Take the first step today. Request an appointment. Axiom Counseling is dedicated to helping individuals discover their inner …

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URL: https://axiomcounseling.com/about/

Therapists & Counseling Services in Wichita Axiom Counseling

WEBOur Services. Axiom excels at offering solutions for people in a variety of situations. Our breadth of experience and abilities is centered on providing holistic care for everyone to …

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Wichita Therapists: Counseling & Spiritual Growth Axiom …

WEBFind us on Facebook. Reach true wellness and live life to the fullest! Take the first step today. Request an appointment. Axiom Counseling center specializes in guiding …

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CLIENT INTAKE INFORMATION

WEBMEDICAL HISTORY: Primary Care Physician Name: _____ Phone:_____ Emergency Contact Name:_____ Phone:_____

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Resources – Axiom Counseling

WEBAddress: 7570 W. 21st St. N. Building 1042, Suite B Wichita, KS 67205. Phone: (316) 239-1880. Fax: (316) 558-8085

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CLIENT INTAKE INFORMATION

WEBWhy are you seeking counseling/therapy? _____ What are your areas of concern? (circle all that apply)

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United Way of the Plains – Axiom Counseling

WEBAddress: 7570 W. 21st St. N. Building 1042, Suite B Wichita, KS 67205. Phone: (316) 239-1880. Fax: (316) 558-8085

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You have the right to receive a “Good Faith Estimate” …

WEBYou have the right to receive a “Good Faith Estimate” explaining how much your medical care will cost. Under the law, health care providers need to give patients who don’t have …

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ATTENTION AND LEARNING CLINIC (ALC)

WEBATTENTION AND LEARNING CLINIC (ALC) Patient Name_____ DOB_____ (2015-1-1) Therapy Acknowledgements and Agreements

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Attention and Learning Clinic

WEBMy personal favorite accommodations include: Specific classroom seating – often near the teacher, away from distractions, and near peers that model good attention and study …

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AUTHORIZATION TO DISCLOSE HEALTH INFORMATION

WEBPatient Name: _____ ID: _____ AUTHORIZATION TO DISCLOSE HEALTH INFORMATION Patient Name: _____DOB:_____ I authorize The Attention and Learning …

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INFORMED CONSENT / THERAPEUTIC AGREEMENT

WEBChallenges in life may lead to anxiety, depression, isolation, and/or other health related problems. Counseling is a unique experience that promotes emotional growth and healing.

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AXIOM COUNSELING INFORMED CONSENT

WEBChild Care Release: Axiom Counseling and Therapy Services, LLC does not provide childcare and is not responsible for children left unsupervised in the lobby.

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