KLC Support Services, LLC

Achieving peace, balance and a more fulfilling life

Client Corner

Here you will find all neces​sary information needed to begin therapy and additional forms you may need during the course of treatment.

The Intake Process

Contact us through email or by phone to speak directly with Kim Censurato, LPC who will talk with you about your concerns and primary reason for seeking services. If agreeable to both parties and clinically appropriate, an  intake will be scheduled.   If telehealth is the preferred, you will receive an email from WeCounsel, the HIPAA and HITECH secure platform, with registration instructions. After registration, the intake forms will be sent to you electronically for completion, or can be downloaded below. During the intake session, all the forms will be reviewed to assess if Telehealth is the right option for you.

In the case of an in office intake session, please complete the intake papers located below prior to the session.  They will be reviewed during the initial session to determine next steps in the treatment process. 

What to Expect

As a client, you can expect professional, competent treatment with the focus on your treatment goals. During the initial session, a therapeutic relationship will begin to form, which is the crucial for successful treatment. By the end of the session, if accepted as a client, you will have next steps and peace of mind knowing you are in good hands. ​

TeleMental Health

According to Delaware code 19 DE Reg. 768 (02/01/16), “ ‘Telemedicine’ means a form of telehealth which is the delivery of clinical health-care services by means of real time 2-way audio, visual, or other telecommunications or electronic communications, including the application of secure video conferencing or store and forward transfer technology to provide or support health-care delivery, which facilitate the assessment, diagnosis, consultation, treatment, education, care management and self-management of a patient's health care by a health-care provider practicing within his or her scope of practice as would be practiced in-person with a patient, and legally allowed to practice in the State, while such patient is at an originating site and the health-care provider is at a distant site."

KLC Supports Services, LLC offers TeleMental Health Services to appropriate clients allowing for the same level of expertise and client focused counseling approach as in office session, but in the comfort of your own home or other confidential location of your choice. This form of therapy has been found to be an effective alternative to in office sessions and the preferred choice by many clients due to the increase in flexibility and convenience. HITECH and HIPPA compliant technology is used to ensure and maintain the highest level of privacy and confidentiality without compromising the counseling experience.

An intake will be conducted prior to the offering of this service to determine if TeleMental Health Services are an appropriate and effective mode of treatment. In addition, many major insurances now cover TeleMental Health. Prior to the session, your insurance will be verified to determine coverage.

Client Forms (Please email completed forms through confidential email ONLY to: [email protected])

New Client Information Form

Client Presenting Concerns and History

Informed Consent and Office Policies

Cancelation Policy and Fee Schedule

Notice of Privacy Practices and Client Rights

Authorization to Release Information 

New Client Complete Packet