Which form form do you need?
If you are wanting to release records to yourself or another person or entity, use the release of information form below.
If you are wanting to add or update insurance with our office, click on the insurance button on the above right.
The form below is to be used by Las Vegas Counseling clients and guardians (for clients who are minors) to request the following:
- releasing patient records to self for use in medical, educational, work or employment settings
- releasing patient records to a third party or agreeing to written or verbal communication about patient records between your therapist and/or the main office and a third party
Please consult with your therapist or office staff if you have questions about filling out this form.
RELEASE OF INFORMATION FORM
The form below is to be used by Las Vegas Counseling to update, change, or add an insurance policy for themselves or their minor children:
Please consult with your therapist or office staff if you have questions about filling out this form.