WELCOME
COUNSELING
SUPERVISION
TRAINING
COMMENTS
STUDENTS
OUR TEAM
OFFICES
DOWNLOADS
LINKS
TERMS OF USE
E-mail Me

Below are some documents for your information and use, as well as Dr. Frial's Practice Brochure.  Please download them as needed. 

 

If you have any questions about the use and/or completion of the document, please contact Dr. Frial at 312-339-6208 or via email at noyfrial@yahoo.com

 

 

 
Authorization for Release and Exchange Information

Use this form to authorize Dr. Norwil C. Frial & Associates, Ltd. to obtain and/or release information about you and/or your treatment.

 

To view and print the Authorization for Release and/or Exchange Information Form, CLICK HERE

 

Or to view and print using Microsoft Word, click on the icon below.

 

 

  Download Authorization_for_Release_and_Exchange_of_Information.doc
Client Rights and Responsibilities

This is a copy of your Rights and Responsibilities as a client of Dr. Norwil C. Frial, NCC, LCPC, CADC.

 

To view and print the Clients Rights and Responsibilities Form, CLICK HERE

 

Or to view and print using Microsoft Word, click on the icon below.

 

 

  Download Client_Rights_and_Responsibilities.doc
Insurance Verification

Use this document when contacting your insurance carrier to determine your benefits and eligibility to receive counseling services with Dr. Norwil C Frial, NCC, LCPC, CADC.

 

You should have this document in front of you while speaking with your insurance representative.  Ask as many questions as possible to complete the document.

 

To view and print the Insurance Verification Form, CLICK HERE

 

Or to view and print using Microsoft Word, click on the icon below.

 

 

  Download Insurance_Verification_Form.doc
Notice of Privacy Practices

This is a copy of Dr. Frial's Notice to Privacy Practices.  Please read this for your information.

 

To view and print the Notice to Privacy Practices form, CLICK HERE

 

Or to view and print using Microsoft Word, click on the icon below.

 

 

  Download Notice_of_Privacy_Practices.doc
Practice Brochure

Download a copy of Dr. Frial's Practice Brochure here.  The brochure has general information about Dr. Frial and Counseling, Supervision and Training Services. 

 

Feel free to make copies and distribute as needed. 

 

To view and print my Practice Brochure using Microsoft Publisher, click on the icon below.

 

 

  Download Practice_Brochure.pub


|WELCOME| |COUNSELING| |SUPERVISION| |TRAINING| |COMMENTS| |STUDENTS| |OUR TEAM| |OFFICES| |DOWNLOADS| |LINKS| |TERMS OF USE|