Triad Counseling & Clinical Services, LLC

806 Green Valley
Suite 301
Greensboro, NC 27408
336-272-8090 Office 336-272-0094 Fax

Karen Elliott - High Point Location
232 Woodrow Ave
Hight Point, NC 27262
336-882-2812 Office 336-882-8632 Fax

Forms

Please download, print, & fill out the appropriate set of paperwork and bring with your insurance card to your scheduled appointment.

Nancy Conrad Ball - ADULT - Patient Packet

Catharine Dowda - ADULT - Patient Packet

Katherine Glenn - ADULT - Patient Packet

Karen Elliott - ADULT - Patient Packet

J. Scott Young - ADULT - Patient Packet

Sara DeHart-Young - ADULT - Patient Packet

Traci P. Collins - ADULT - Patient Packet

CHILD - Patient Packet
(please also print, sign and bring in Professional Disclosure Statement for your individual therapist loacted to the side )

Existing patient update paperwork

Additional information to print with child paperwork only:

Nancy Conrad Ball - Professional Disclosure Statement

Catharine Dowda - Professional Disclosure Statement

Katherine Glenn - Professional Disclosure Statement

Karen Elliott - Professional Disclosure Statement

J. Scott Young - Professional Disclosure Statement

Sara DeHart Young - Professional Disclosure Statement

Traci P. Collins - Professional Disclosure Statement

United Behavioral Health (UBH) members:
We ask that you fill out this additional form and bring it in addition to your other paperwork. Your insurance requires that you fill out this form and that our office fax back and keep on file.

(adult) https://www.ubhonline.com/html/alert/pdf/briefWellnessAssessmentAdult.pdf
(child) https://www.ubhonline.com/html/alert/pdf/briefWellnessAssessmentYouth.pdf

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