Terri Schmidt, LCSW

Therapy & EAP Corporate Consulting

Terri Schmidt, LCSW

Therapy & EAP Corporate Consulting

Phone Icon 847-827-7639

terrinschmidt@gmail.com

While I would prefer to meet with you in person, due to Covid-19 we will have to meet virtually for a while.  I am well aware that your privacy is extremely important, so I will do my absolute best to ensure that confidentiality is maintained.  For me to do that, please read and complete two forms  – the Statement of Understanding and the Client Information.  Complete all fields and then click the Submit button.  All information is transmitted securely.  Please click here to read and complete the two forms.

We will get thru all this together!

1.  Statement of Understanding

This is a very unusual time for all of us. Illinois mental health providers have received an Executive Order from the governor. We are allowed to provide telehealth services in whichever way best suits our clients. This includes telephones, two-way videos, Facetime, and so on.

I am doing my best to be mindful of both your privacy and physical well-being. I will be providing telehealth services in the privacy of my home office. No in-person office visits will be provided until the Illinois quarantine is over.

Many insurance companies are waiving both deductibles and co-pays until the danger of this virus is gone or greatly diminished. Please check this out with your insurance company.

Please note my request to give 24-hour notice to reschedule or cancel an appointment.

Your electronic signature indicates your understanding and agreement of this plan.

Hopefully we will see each other live and in-person soon! In the meantime, let’s all do our best to stay safe and healthy, remembering that this too shall end.

    Terri

 
 

2a. Client Information

 

2b. Contact Information

 

2c. Emergency Information

 

2d. Insurance Information

 

Verification

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Terri Schmidt’s Website

“Spanning the mental health spectrum from corporate administrations to critical patient needs, to an understanding dialogue with a colleague or friend, Terri Schmidt, is always there for those in need. With an imposing and extensive academic background in mental health that is balanced with her all-embracing wide-ranging compassionate experience, she leads patients upon a path of self discovery, understanding, and treatment, in a world unfortunately immersed in stress, chemical dependency, and mental health issues. Setting problems and challenges upon a path of healing, Terri Schmidt makes the world a better place for us all.”

Dr. Robert Rail

“Surviving the International War Zone”

CALL ME:

847-827-7639

FAX ME:

847-292-0512

EMAIL ME:

terrinschmidt@gmail.com

VISIT ME:

1580 N. Northwest

Highway, Ste. 121-F
Park Ridge, Ill. 60068

CALL ME:

847-827-7639

EMAIL ME:

terrinschmidt@gmail.com

VISIT ME:

1580 N. Northwest

Highway, Ste. 121-F
Park Ridge, Ill. 60068

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