Arlucent Assessments | SimplePractice

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Administrative

Do you understand that Arlucent Assessments provides independent evaluations only and does not offer therapy, counseling, treatment, or referrals to specific providers?

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Are you seeking any of the following? (Select all that apply)

Selecting any of the first five options may indicate that Arlucent services are not appropriate for your situation.

Therapy or counseling Crisis intervention or immediate support A referral to a specific treatment program Ongoing case management A letter or report supporting a predetermined outcome None of the above

For medical emergencies, contact your healthcare provider or call 911. For mental health crises, call or text 988.

By submitting this form, you agree to the processing of your sensitive personal information, which may include protected health information (PHI). This information may be viewed by team members in this practice. You also agree not to submit any payment information, including credit or debit card details, through this form.