JEFF LUTES, LPC
Hello
ALL NEW CLIENTS: Please click the button below to complete and sign each section of the Personal History & Consent for Therapy form prior to the first session. For couples therapy, each partner should complete a separate copy of this form:
New Client Forms
Group Therapy Clients: In addition to the Personal History & Consent for Therapy form, please take a moment to read and sign the Group Agreements:
Insurance: I accept Aetna and BCBS of Texas only. If you are covered by either of these insurance companies, please complete the form below. My office will call the insurance company to verify benefits. If you have insurance other than Aetna or BCBS, do NOT complete this form. Instead, I can give you a statement each month that you can file to receive reimbursement.