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LETTER TO CURRENT CLIENTS
LETTER TO CURRENT CLIENTS
Dear Clients,
Out of an abundance of caution and our strong commitment to meeting the needs of our clients (inclusive of your safety and ours), we will continue to provide alternative counseling formats where appropriate (via Telehealth) to alleviate the need for in-person contact.
Additionally, for our current clients, we will need updated Authorization and Communication Forms - please see below.
Thanks so much. We look forward to 'seeing' you soon!
Best regards,
Penny Siegmann, LCSW-R
Owner
Counseling Services of Long Island, LCSW PC
2021 FORMS (for Current Clients) - ADULTS
2021 FORMS (for Current Clients) - ADULTS
Please
Review, Sign & Return:
via Confidential Fax (516-804-0448),
Mail (54 Chicago Ave, Massapequa NY 11758),
or Drop-Off to the Massapequa office.
(If drop-off, please put in a sealed envelope, and leave in the mailbox, or place envelope in a bag hang
on the inside of the front house door.)
2021
AUTHORIZATION FORM - ADULTS
2021
AUTHORIZATION FORM - ADULTS
2021 FORMS (for Current Clients) - CHILDREN (< 18 years old)
2021 FORMS (for Current Clients) - CHILDREN (< 18 years old)
Please
Review, Sign & Return:
via Confidential Fax (516-804-0448),
Mail (54 Chicago Ave, Massapequa NY 11758),
or Drop-Off to the Massapequa office.
(If drop-off, please put in a sealed envelope, and leave in the mailbox, or place envelope in a bag hang
on the inside of the front house door.)
2021
AUTHORIZATION FORM - CHILDREN
2021
AUTHORIZATION FORM - CHILDREN
PAYMENT OPTIONS FOR TELEHEALTH
PAYMENT OPTIONS FOR TELEHEALTH
For your convenience, we've streamlined session fee/copayment options
to include the use of the following services...