| Heritage Registration Form |
| HIPPA Policies and Practices Form |
| Disclosure and Permission Form |
| Insurance Benefit Information |
| Release of Information Form |
| New clients register by downloading the forms, printing them, and completing them |
| In addition to his office at Heritage Counseling Associates, Roger is available to see clients in other locations as well. |
| On Mondays, Roger is in Lake Stevens |
| (Click Here to View the Map.) |
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| On Thursdays, Roger is in Kirkland |
| (Click Here to View the Map.) |
If you will be seeing Roger in Lake Stevens or Kirkland, please bring a copy of the front and back of your insurance card to give to roger so we can bill your insurance company for your visit. |
