Recovery NOW, Inc.

Office Locations · Hermosa Beach · Palos Verdes Estates · San Pedro · Phone: (310) 508-9531

 

HOME

Professional Login

New Client Information

Locations & Directions

Payment

Services

Psychotherapy

Recovery Coaching

Moderation Mgmt. Group

Postpartum Support Group

Interventions

EMDR

Concierge Services

Pills Support Group

Relapse Prevention

Providers

About Alicia

About James

About Pamela

About Whitney

Substance Abuse

Resources Drug/Alcohol

Addiction Scale

Alcoholism Self-Test

Codependency

Codependency Resources

Codependency Self Test

Postpartum Depression

PPD Resources

PPD Self-Test

Mental Health/ADHD

Resources

Depression Screening

ADHD Self-Test

News & Events

 
New Client Information
Welcome

In order to avoid problems with insurance verification, please complete the following form and email back atleast 2 days before your first appointment.  There are 2 options for providing this Information.  
 

Confidentiality Assured by the following steps:

Option 1
1.  Save first in your own My Documents
2.  Make changes
3.  Email Attachment, RecoveryNowAM@gmail.com

                           
Option 2
1.  Complete Online Form By Entering Client Information
2.  Scroll Down and Insert All Requested Information
5.  Make Sure to Click Submit Button at the Bottom of the Form

Thank you and I look forward to meeting with you.


Option 1

Document Library

NameDescription
DocumentNew Client InformationClient Face Sheet
 
Option 2
Data has been encrypted when submitting client information online in order to assure confidentiality.
 


 
 HOME  |  New Client Information  
  
Substance Abuse  | Codependency  |  Postpartum Depression  |  Mental Health & ADHD 

  Services & Providers  | 
News & Events 


© 2010 Recovery NOW Licensed Clinical Social Worker, Inc.

Website powered by Network Solutions®