"Start where you are, use what you can, do what you can." 
Arthur Ash
"Your present circumstances do not determine where you can go; they merely determine where you start."
Nido Qubein
Mental Health Counseling

“You don’t have to see the whole staircase to take the first step.”

Martin Luther King

Intake Forms

Intake Forms

Please complete and email the intake paperwork prior to your first appointment to alarusdocuments@gmail.com. You may also print and bring the completed forms if you are unable to email them.

If you are unable to complete the forms at home, please arrive 30 minutes prior to your appointment to fill them out in the office. Thank you!

Alarus Healthcare, LLC wants you to be aware of your rights as a client and asks for your informed consent to receive treatment.
Admission Agreement-Informed Consent

Authorization for release of information in case of injury or illness at the office.
Release of Information for Emergency Contact

Alarus Healthcare, LLC wants you to be aware of your rights as a client and asks for your informed consent to receive treatment via telehealth/virtual services.
2021 Telehealth Informed Consent

Alarus Healthcare, LLC strives to accommodate for every client’s schedule- with this form, we can set your appointment confirmation to your preferred method.
Appointment Reminder Preference Form

This form will help your clinician get an overall picture of your situation. 
Adult Family History
Child-Adolescent (Under age 15) History

Alarus Healthcare, LLC gives you this notice that describes our legal duties and privacy practices. 
Privacy Notice

Explanation of insurance practices within our office and patient financial responsibility.
Assignment of Benefits

Mental health counseling, substance abuse counseling, behavioral health services, medication assisted treatment.

Alarus Healthcare, LLC.

Mental health counseling, substance abuse counseling, and behavioral health services

Crisis help. If you need immediate help, please reach out to your local county crisis

Dodge County Human Services – Crisis: (920) 386-3489

Ozaukee County Human Services – Crisis: (262) 284-8200. Suicide Hotline Ph:988

Washington County Human Services – Crisis: (262) 365-6565

Community Help Services

211-Impact (free, confidential helpline in times of crisis or community services such as housing): call 414-256-4808 or text 898-211.

Contact us • Alarus Locations • Treatments Offered • Beaver Dam Clinicians • Grafton Clinicians • West Bend Clinicians • Intake Forms • Insurance Rates • Referral Form • Grant Scholarship/Hardship Assistance