New Leaf Resources

New Client Forms

Important New Client Form Instructions During COVID-19 Pandemic

As Illinois and Indiana start moving through phases of re-opening, we would like to keep you in the loop of our plans.

We are currently in the process of adding all necessary safety measures to our offices in order for us to feel comfortable about inviting clients back. These include:

  • Plexiglass Sneeze Guards
  • Hand Sanitizer
  • Masks for Clients and Providers
  • Non-Contact Thermometers

Once these products are delivered and installed, we will finalize a date for a limited re-opening of the facilities. IN-PERSON APPOINTMENTS WILL BE AT THE DISCRETION OF YOUR PROVIDER.  YOUR PROVIDER OR THE OFFICE STAFF WILL NOTIFY YOU WHEN THESE APPOINTMENTS BECOME AVAILABLE.

Telehealth has been an amazing opportunity during these trying times and we encourage anyone who is currently looking to see a provider to consider this option. If you are interested in scheduling a telehealth appointment, please call us at 708-895-7310.

* If you are scheduled for a video session, please make sure your forms are completed PRIOR to your scheduled appointment so that they can be uploaded or drop off or fax the forms to New Leaf's office.  If you are scheduled for a phone session, forms must be completed, signed, and at New Leaf's office prior to your scheduled appointment.

New Client Form Instructions for In-Person Sessions

  • Please read through the entire packet of information.
  • Either print the blank paperwork and fill it out by hand or you can answer the forms on your computer and then print out the completed documents.
  • When couples or other family members are attending counseling together, each adult attending any session must complete both a "Consent and Agreement for Treatment" form (page 4 of adult packet, page 5 of minor packet).
  • Each minor attending any session must have a completed "Consent for Treatment of a Minor" form (page 4 of minor packet), for the therapists' records. 
  • It is also helpful for the therapist to have a "Client Data Sheet" (pages 5-6 of adult packet) and a "Client Data Sheet - Youth" (pages 6-7 of minor packet) for each person attending therapy, although these forms are only required for the primary client.

Please remember to bring all of your paperwork to your first appointment.  Thank you.  

 

Please note:  If you are having difficulty viewing these files, we recommend trying a different browser (Internet Explorer, Google Chrome, etc.) or downloading the form(s) to your computer.  You need the newest version of Adobe Reader to view these forms.  Adobe Reader is free and available at: