FOR THERAPY ONLY

Step 1. Schedule an appointment by calling 877-316-3082 

*Step 2. Complete – TSPCC Counseling Intake Form Editable (<—click here)

*Step 3. Complete – Provider Choice Form (MEDICAID AND NC HEALTHCHOICE ONLY)

*Step 4. Complete – CONSENTS FORMS TO BE SIGNED  (click here)

Step 5. Review – TSPCC HIPAA Notice of Privacy Practices Updated (<—click here)

Step 6. Review & Keep – Nanette’s Professional Disclosure  (<—click here)

Step 7. After completion, save documents to your computer. Then, open your email service and attach the document and send Intake Form, Provider Choice, and Consent for Services to nanette@the-seed-planter.com. Keep Notice of Privacy Practices for your records.

You can type directly on forms. Please note wherever require a signature, if you type your signature, type “Electronic Signature” beside the signature.  

If you have any difficulties, you can print forms out at fax to our confidential line 877-316-3082 or you can bring it with you or drop it into the mail slot.

Step 8. If you have Blue Cross and Blue Shield, contact customer service (or we can do this for you) and ask what your co-payment is for mental health counseling AND if you have a deductible.   We can accept cash or credit/debit card and most flexible benefit cards. 

Step 9. Make sure you bring your insurance card and identification with you.

NOTICE: Virtual appointments are available.

 FOR REFERRALS

Step 1. Complete referral form (click here)

Step 2. Fax to 877-316-3082 or call 877-316-3082

SHARE WITH A FRIEND, CHURCH OR OTHER FAITH ORGANIZATION

Step 1. Right-click on picture below and Save-As

Step 2. Open email, attach picture

Email us at nanette@the-seed-planter.com