Forms:
Client’s Rights
Privacy Practices
Intake Form – Child
Psychosocial History (Intake Form – Adult)
Office Location: 100 W. Franklin St., Baileyville, IL
Mailing Address:
P.O. Box 76
Baileyville, IL 61007
Email: [email protected]
Phone:
(815) 266-9456
Fax:
815-315-0984
Insurance:
I accept the health insurances listed below, and I am willing to become a provider approved by your insurance company if it is not listed. Please don’t hesitate to contact me with questions regarding your insurance.
