Without Hope There is No Help
Auburn Remote Hippa Compliant Remote Therapy - Teletherapy
The program we use is called Vsee, it is HIPPA compliant and all information is secure and will not be saved other than in your client file as a record of the service provided.
Phone: (253) 333-2328
Fax:  (253) 333-5068
Address: 230 Auburn Way S. Suite 1B
Auburn, WA. 98002

Client Insurance Form

Patient Information:


Emergency Contact:

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Primary Insurance Information:


Secondary Insurance Information:


Assignment Of Benefits: I hereby authorize Hope + Help Counseling to release or obtain any information necessary to process insurance claims for services rendered to me or my dependent. I also authorize benefits to be paid directly to Hope + Help Counseling. I understand that I will be responsible for co-pays, deductibles and any balances remaining after insurance has paid.


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(253) 333-2328
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Auburn, WA