Forms | A Talk with John

Please review the New Client Forms below; complete the Information/Acknowledgement/Consent provided below prior to your first therapy session so time will not be spent filling out forms during your appointment.

**Accepting Insurance:

Aetna | BCBS | Optum Health/ United Healthcare |Medcost |CBHA

-We do not accept EAP nor do we complete any Medical Excuses, Leave or Workers' Comp Claims

*Attention Clients: Once you've set up an appointment, please check your email for a

Therapy Notes Client Portal access message where you will be able to create a login.*

Client Portal

Client Information/Acknowledgement/ Consent

*Patient Waiting List:
(If an appointment is unavailable and you would like to be added to the waiting list)

A Talk with John Counseling and Consulting, PLLC

Therapy for Individuals, Couples and Families

Charlotte, North Carolina

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Client Information/Acknowledgement/ Consent

*Patient Waiting List: (If an appointment is unavailable and you would like to be added to the waiting list)

A Talk with John Counseling and Consulting, PLLC

Therapy for Individuals, Couples and Families

Charlotte, North Carolina

*Patient Waiting List:
(If an appointment is unavailable and you would like to be added to the waiting list)