110 W. Linden Dr, Suite B, Jefferson, WI 53549

phone 920-674-5050

phone 920-674-5050

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  • Services
  • Therapists
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  • Appointments
  • Forms/Portal
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  • More
    • Home
    • Services
    • Therapists
    • COVID-19
    • Appointments
    • Forms/Portal
    • The clinic
    • My balance
    • Employment
    • Resources
  • Home
  • Services
  • Therapists
  • COVID-19
  • Appointments
  • Forms/Portal
  • The clinic
  • My balance
  • Employment
  • Resources

Restoring Balance Counseling, LLC

Restoring Balance Counseling, LLCRestoring Balance Counseling, LLCRestoring Balance Counseling, LLC

Providing Jefferson & surrounding communities quality mental health therapy

Providing Jefferson & surrounding communities quality mental health therapyProviding Jefferson & surrounding communities quality mental health therapy

client portal

The Client Portal is intended to be a convenient resource to check scheduled appointment times and review and sign documents sent to you by the practice to continue services.


If you are a CURRENT CLIENT of RBC, LLC and don’t have a portal account yet, please request one during your next visit or contact Jeremy at jeremy@restoringbalancecounseling.com.  Once you receive an email invitation to the Portal, please go to the HOME PAGE and press the green button for access (current clients only). 


If you are a potential NEW CLIENT, you will not have access to the Client Portal until you contact Jeremy.  After giving some general information regarding you/your child, and issues to address in therapy, and it appears that therapy is  appropriate and medically necessary at this time, you will receive an email invitation to the Portal.


Connecting to Client Portal

Click on the CLIENT PORTAL button on the HOME PAGE to be directed to the portal (this button below will not take you there and is just to show you what it looks like)

CLIENT PORTAL

Forms to fill out

Below are most of the forms that will be filled out prior to your Initial Assessment with Restoring Balance Counseling, LLC in Jefferson, WI.  You are welcome to download, fill them out, and mail or fax them back.  We do not recommend emailing forms unless you have a secured system that encrypts documents.  A safer, more secure, and HIPAA compliant way to complete forms is to receive them through our secure Client Portal.  If you do not feel comfortable, are unable, or have questions about filling them out, no problem!  We will be happy to assist and answer any questions you may have.  Contact us at jeremy@restoringbalancecounseling.com .


Outpatient Client Information Form 1-22 (pdf)Download
Client Rights and Informed Consent 1-22 (pdf)Download
Release of Information 1-22 (pdf)Download
Email Consent 1-22 (pdf)Download
Teletherapy Consent and ROI 1-22 (pdf)Download

Downloads

Below are supplemental forms and brochures to review and print to keep you informed of Restoring Balance Counseling, LLC policies, as well as your rights as a consumer of mental health services.  These forms are the items you are initialing for in the FORMS TO FILL OUT section above and on the documents sent to you from the Portal.  If you are unable to review or print the documents, please ask and we will be happy to mail you copies.

Child rights brochure (pdf)

Download

Client rights brochure (pdf)

Download

Involuntary discharge policy (pdf)

Download

HIPAA (pdf)

Download

Payment Policy (pdf)

Download

Copyright © 2018 Restoring Balance Counseling, LLC - All Rights Reserved.


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