New clients will need to fill out several forms before therapy can begin. To make the process as smooth and efficient as possible, these documents may be downloaded from the below list. Naturally, all forms are also available at the office but filling them out in advance saves time if you are able to. You will need Adobe Reader to view these PDF files. If you do not have it, you can download it here for free.
For any Colorado residents are interested in paying for sessions without using insurance (i.e. Self Pay), please see the form below entitled "Good Faith Estimate Agreement." For any North Carolina residents interested in therapy, Self Pay is the only option at this time.
All of the forms with an * below are required for clients residing in Colorado. If you are unsure of which forms you need to fill out, please don't hesitate to contact Amber W. Pearson via email or text.
For clients who are Self-Pay (i.e.: people wo are not using insurance) the following form is required and includes options in accordance to Good Faith Estimate requirements:
This form is not required for all clients, but is included if needed.
All forms with an * below are required for clients outside of Colorado. If you are unsure of which forms to fill out please contact Amber W. Pearson via e-mail or phone.
Only teletherapy (online/virtual) services are being provided. No in-person services are available at this time.
Amber W. Pearson is a Licensed Professional Counselor (LPC) in Colorado, a Licensed Clinical Mental Health Counselor (LCMHC) in North Carolina, and a Licensed Mental Health Counselor (LMHC) in Washington state and can provide services in any of these states. Amber can also provide services to clients who reside in states that don't require a license in that state for Teletherapy service provision.
5150 W. 120th Ave, Suite 100, #1057
Westminster, CO 80020
North Carolina Address:
2509A Lewisville Clemmons Rd. #1033
Clemmons, NC 27012