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New Clients

Making the decision to get help can be hard.  We understand.  

That’s why we’re committed to doing everything we can to make your path toward mental wellness as smooth as possible.  From the first time you pick up the phone to call us, our kind and compassionate staff will help you every step of the way.  

Making the decision to get help can be hard.

we understand

We’re glad to be a partner with you in your road to recovery. This page is intended to provide you with the necessary information to help ease any anxiety you may be feeling regarding your care from our team.

  • SCHEDULING YOUR FIRST APPOINTMENT
  • FORMS
  • PAYMENT INFORMATION
  • FEES

The first step to getting the help you need is to call our office at (574) 277-0274.  Our well-trained and compassionate staff with work with you to find the therapist that is best suited to fit your needs.

At Seasons Counseling of Michiana, we understand that individuals and families have busy schedules. We can schedule your appointment for daytime or evening hours. Call our client specialists Monday - Friday, during normal business hours, to make your first appointment.

Thank you for choosing Seasons Counseling of Michiana. If you are coming for the first time or after a long absence (6 months or more), please print the applicable forms and bring them to your first appointment.

Client Registration Form

All new clients and clients returning after more than six months since last session must complete this form. Please print and bring to your first appointment.

Counseling and Fee Agreement Form

This is for your information. You don’t need to bring it to your appointment, but be aware that by signing the Client Registration and Insurance Agreement forms, you are agreeing to the policies detailed here.

Insurance Agreement Form

If you would like us to bill your insurance company for services, please print this form. Bring the completed form and your insurance card to your first session.

Authorization to Disclose Information Form

This forms grants us permission to disclose information regarding your appointment to your primary care physician or referring professional.

Authorization to Release Appointment and Billing Information Form

 If you would like someone close to you (such as a spouse, parent, etc.) to be able to call and schedule or cancel appointments on your behalf or talk with us concerning billing matters, please print and complete this form.

General Release of Information

This form provides you the opportunity to 1) send your records to another care provider and/or 2) request records from another provider be sent to Seasons Counseling of Michiana.

HIPAA notice to clients

This notice tells you how we make use of your health information at our Center, how we might disclose your health information to others, and how you can get access to the same information.  There is no signature required on this form

Seasons Counseling of Michiana accepts many different forms of payment.

  • Insurance: we are able to accept a wide variety of employee-sponsored and individually purchased insurance plans.
  • Employee Assistance Plans (EAPs): Check with your Human Resources department to see if you are eligible for free counseling sessions without having to utilize your insurance benefits.
  • Medicare
  • Self pay
  • Client Assistance Fund: Intended for clients who are uninsured or underinsured, our CAF can help ease the burden of the cost of sessions.  Call our office to learn more about the application process.
  • Congregation Assistance Program: through partnerships with area churches and places of worship, some clients are eligible for reduced fees through a church-sponsored voucher program.  Call our office to find out if your place of worship participates.

The Samaritan Counseling Center is a non-profit organization. Our standard rates for a 45 minute session are $145 for the initial assessment and $110 for subsequent sessions. Payment is expected at time of service.

We offer a variety of payment options. We accept insurance and are in-network providers for a variety of HMO’s and managed care organizations. Additionally, in special circumstances, a portion of the client’s fees may be subsidized through the Client Assistance Fund, funded by donations. Also, check with your congregation to see if they are a part of our Congregation Assistance Program for additional assistance.

Parking & Directions

Parking

Our main office is located on the campus of Christ the King Lutheran Church, at 17195 Cleveland Road in South Bend.  When you arrive, follow the main drive around toward the back (north) side of the building to the large parking lot. When facing the building, our office entrance is located on the left side, marked by our sign.

Our satellite office is located on Clay Church’s Firehouse Campus, at 17646 Cleveland Road in South Bend.  Season’s entrance, marked by our sign, will be immediately to your right, parking available in the circle drive or in the lot.

Make the decision to get help today.

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