COUNSELING CONNECTIONS ADK
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  • Counseling Services
  • Couples Workshop
  • Peak Performance
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  • Home
  • About
  • Counseling Services
  • Couples Workshop
  • Peak Performance
  • Info
  • Contact

Useful Information & Forms

Insurance Plans Accepted:
Excellus BlueCross BlueShield
Other insurance plans may also be available. Please feel free to contact us with any questions.
Payment Methods:
Cash
Personal Checks
PayPal
​(Sliding fee scale is available in appropriate situations)
Practice Forms:
Consent for Release of Confidential Information
Consent for Release of Confidential Information
Please read your HIPAA Rights and then download, print, and sign the HIPAA Acknowledgement Letter
HIPAA Rights
HIPAA Acknowledgement Letter
Payment Form
Payment Form
Contact Gina

GINA JADWISIAK, LCSW
518-523-6516

Counseling
couples workshops
Peak Performance Training


COUNSELING CONNECTIONS ADK
​88 CHURCH Street
​Saranac Lake, NY


Forms and Info

Couples Workshop registration

register
Counseling Connections ADK - all rights reserved 2018