Welcome to Cord of Three Counseling Services, Inc.
Cord of Three requires certain paperwork and items to be brought with you to the first counseling session and delivered to your therapist. Please print, read, and complete the appropriate paperwork and remember to bring your paperwork with you to the first session.
If you want to fill out your paperwork online: click on the Pimsy link to the right.
Complete the information to the best of your ability and save any questions you may have for your therapist. Your therapist will need to collect all information prior to the start of your session. You will also be expected to make a payment at the time of the counseling session unless told to do otherwise. Please make checks payable to Cord of Three.
If you want to print and fill out your paperwork, please click on the links below, print, fill them out and bring with you to the first session with your intake counselor:
Cord of Three requires certain paperwork and items to be brought with you to the first counseling session and delivered to your therapist. Please print, read, and complete the appropriate paperwork and remember to bring your paperwork with you to the first session.
If you want to fill out your paperwork online: click on the Pimsy link to the right.
Complete the information to the best of your ability and save any questions you may have for your therapist. Your therapist will need to collect all information prior to the start of your session. You will also be expected to make a payment at the time of the counseling session unless told to do otherwise. Please make checks payable to Cord of Three.
If you want to print and fill out your paperwork, please click on the links below, print, fill them out and bring with you to the first session with your intake counselor:
Please select the appropriate form below which fits your needs:
Informed Consent (Everyone must fill out)
Counseling Form
If you have a Child or Adolescent coming in for treatment and you would like for your therapist to contact his/her school, youth pastor, or any other individual you feel is pertinent to understanding your child's mental health, please print out and bring with you a completed release of information form below:
We do not have a receptionist at all of our counseling sites. Your therapist will be coordinating all of your needs at your counseling session. Upon your arrival, your therapist may still be completing a session with another family. If that is the case, please wait a few minutes and your therapist will be right with you. If you have any questions upon arrival at your appointment, feel free to contact our secretary at 912-282-0992. If you need directions to the location of your counseling session, see Locations.
Your first session will primarily be used as an assessment of your circumstances. The therapist will ask questions relating to current situations and past histories and together you will create a plan for your treatment. Be prepared to provide a list of all medications as well as personal and family histories.
At the conclusion of your session it may be determined that we need to do an additional evaluation with you. If that is the case, your therapist will discuss the appropriate fees of the evaluation with you (some assessment fees are not covered under insurance). Your therapist will also handle any follow-up counseling sessions with you and together you will find an appointment time that works with your schedule. You will be expected to pay for the session at the conclusion of the appointment. Cord of Three accepts check, cash, or credit card, please make checks payable to Cord of Three.
Cord of Three works with every client to make use of any available benefit. Our administrative assistant will work with you to determine a cost that is affordable to you. We do not want the cost of counseling to be a barrier to you receiving the help you need. If you would like to use your insurance, please confirm the following information before you call Cord of Three:
It is helpful for you to verify this information PRIOR to your first appointment. Our administrative assistant is available to assist you in whatever way she can to make this process as convenient for you as possible.
Cord of Three is dedicated to providing you with excellent services in a comfortable, safe, and private environment. If at any point, you feel that your rights as a client or your safety have been compromised, you may share your concerns with Cord of Three by calling 912-282-0992 and asking to speak with our Executive Director or the Chair of our Board. All concerns are kept confidential.
Welcome to Cord of Three!
Should you need financial Assistance for counseling, please complete the form below and call Leslie to schedule at apt. at 912-282-0992
Informed Consent (Everyone must fill out)
Counseling Form
If you have a Child or Adolescent coming in for treatment and you would like for your therapist to contact his/her school, youth pastor, or any other individual you feel is pertinent to understanding your child's mental health, please print out and bring with you a completed release of information form below:
We do not have a receptionist at all of our counseling sites. Your therapist will be coordinating all of your needs at your counseling session. Upon your arrival, your therapist may still be completing a session with another family. If that is the case, please wait a few minutes and your therapist will be right with you. If you have any questions upon arrival at your appointment, feel free to contact our secretary at 912-282-0992. If you need directions to the location of your counseling session, see Locations.
Your first session will primarily be used as an assessment of your circumstances. The therapist will ask questions relating to current situations and past histories and together you will create a plan for your treatment. Be prepared to provide a list of all medications as well as personal and family histories.
At the conclusion of your session it may be determined that we need to do an additional evaluation with you. If that is the case, your therapist will discuss the appropriate fees of the evaluation with you (some assessment fees are not covered under insurance). Your therapist will also handle any follow-up counseling sessions with you and together you will find an appointment time that works with your schedule. You will be expected to pay for the session at the conclusion of the appointment. Cord of Three accepts check, cash, or credit card, please make checks payable to Cord of Three.
Cord of Three works with every client to make use of any available benefit. Our administrative assistant will work with you to determine a cost that is affordable to you. We do not want the cost of counseling to be a barrier to you receiving the help you need. If you would like to use your insurance, please confirm the following information before you call Cord of Three:
- Decide if you plan on using your insurance. Cord of Three is required to submit a mental health diagnosis on all clients receiving behavioral health services to the insurance company. Many clients do not want their records to include a behavioral health diagnosis. The only insurance companies we will bill are: Blue Cross/Blue Shield, United Healthcare, EAP, Wellcare, Amerigroup, Cenpatico, and Caresource. If you do not have one of these insurance providers, we will work with you to make sure the cost is not a barrier to counseling.
- Verify that your plan covers behavioral health services, what the co-pay amount is and what your deductible is. Many insurance plans have a separate deductible for behavioral health services than for medical services.
- Does your plan cover individual, family, couples or group therapy?
- Are our therapists covered as in-network for your insurance plan?
- Do you need prior authorization for services to be covered? If so, you will need to call your plan for prior authorization, our administrative assistant will be glad to assist you in this matter.
It is helpful for you to verify this information PRIOR to your first appointment. Our administrative assistant is available to assist you in whatever way she can to make this process as convenient for you as possible.
Cord of Three is dedicated to providing you with excellent services in a comfortable, safe, and private environment. If at any point, you feel that your rights as a client or your safety have been compromised, you may share your concerns with Cord of Three by calling 912-282-0992 and asking to speak with our Executive Director or the Chair of our Board. All concerns are kept confidential.
Welcome to Cord of Three!
Should you need financial Assistance for counseling, please complete the form below and call Leslie to schedule at apt. at 912-282-0992
