Moss Counseling
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Accepted Insurance

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  • Aetna
  • Blue Cross/ Blue Shield
  • CIGNA
  • Humana
  • North Carolina Health Choice
  • North Carolina Medicaid
  • South Carolina Medicaid
  • TriCare
Counseling Session

Patient Forms

Referral Application (New Clients/Private Insurance)
File Size: 46 kb
File Type: pdf
Download File

Notice of Privacy Practices
File Size: 280 kb
File Type: pdf
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Statement of Client Rights
File Size: 313 kb
File Type: pdf
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Statement of Confidentiality
File Size: 84 kb
File Type: pdf
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Counseling Agreement
File Size: 203 kb
File Type: pdf
Download File

Authorization to Release Information
File Size: 344 kb
File Type: pdf
Download File

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