Thank you for your interest in Amigo Family Counseling

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1. If you are planning to use insurance, you will need your insurance card to complete the form.

2. Click on and fill out all areas of the following: 
    

3. Once we receive the New Client Intake Form, we will reach out to you to answer any questions you might have before starting services (via phone or email).

4. To learn about Amigo Family Counseling's financial, insurance, and funding information, see our "Financial Information" section below.

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Note: ​Follow up phone calls for intakes are generally made Tuesday - Thursday, 6:30pm - 9:00pm. The Phone # associated with follow up calls is (614) 310-1234. 

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*Please be aware that not all electronic correspondence, i.e. email, FAX, etc., to and from Amigo Family Counseling, LLC (AFC) is encrypted. Unencrypted correspondence carries certain levels of risk, for example, the information could be read by an unintended third party. However, our intake form and correspondence from our Hushmail account is encrypted.  As a covered entity, AFC cannot be responsible for any unauthorized access. 

If you have medical insurance, we ask that you contact your insurance for specific coverage/benefits information. If you have county funding or funding from other sources, please contact that source for details about your coverage for services.

Before you have been contacted to schedule your first appointment one of our staff will send you our New Client Paperwork that MUST be completed before your first appointment. We have provided a sample of the forms so you know what kind of information is required.