get startcontact

Step One: Call 815-777-2850 to make an appointment
Or, email Dr. Gabbert at itc@interactionstherapycenter.com.
Step Two: Download and complete the Intake Form, the Claim Form and the Privacy Form
Step Three: Bring the forms with you to your appointment

Intake Form

Privacy Form

      Claim Form

(please complete the top half of the claim form and sign in both places)

In addition, if you will be using Tele-Counseling please also fill out these forms and send them to Dr Gabbert via email or fax.

Communication Consent Form

Group Tele-Counseling Agreement

Tele-Counseling Services Agreement

 

Don’t forget to bring your completed forms with you or send them before your first session! 

Fax? sure!    815-777-1308

 INTERACTIONS THERAPY CENTER
939 Galena Square Drive, lower level
Galena, IL 61036
815 777 2850