- Please complete required forms requested by the OSHCC Intake Coordinator and/or the Therapist. Once complete, please email to https://sendsafe.to/[email protected] or fax to 1-866-898-9031. If additional forms are requested they would be provided by the Coordinator or Therapist.
- Authorization for release of information
- Referral Form
- Client Intake Form
- Counseling Center Consent
- Self-Care Assessment
- Five Love Languages Assessment
- Parental Stress Scale
- Short Mood and Feelings Questionnaire
- Life Events Questionnaire
For Spanish version please send us an email using the “Contact Us” below the tab.
Our service fees are fixed; however, we offer a sliding scale of fees that can lower the amount you pay. You may be eligible for a fee discount based on household size and income and any unusual circumstances. You can oshcc-sliding-fee-application.pdf if you want to request the sliding scale. Please let us know of any significant changes in your financial status. You may request a review any time should you require a fee adjustment. Note: “Therapy packages” are not eligible under the Sliding Fee Schedule. EAP clients do not pay for services if your active units are approved through your EAP provider.
Good Faith Estimate:
Following being accepted for services, we will discuss fees with you and the cost of care, including providing you with an estimate of the cost of services. All clients are entitled to a Good Faith Estimate that will be given in writing and verbally upon request.