Declaration of Practices and Procedures: Each Granberry Counselor has a Declaration of Practices and Procedures. Please click the name of your Counselor below, print out and read their form. Please sign the form and bring it with you to your appointment. Thank you.
"Right to Receive a Good Faith Estimate of Expected Charges"
Under the No Surprises Act
You have the right to receive a "Good Faith Estimate" explaining how much your medical care will cost.
Under the law, health care providers need to give patients who don't have insurance or who are not using insurance an estimate of the bill for medical items and services
For questions or more information about your right to a Good Faith Estimate, visit www.cms.gov/nosurprises or call Granberry Counseling Centers at 318-345-8200.
These forms are available to you to read and fill out prior to your first visit.
Consent to use & disclose your health info
Mental Health Consumers' Rights
Request/Authorization to Release Confidential Records and Information
Your gift provides love, care, and hope in Christ for children and families in need. 74% of all funding comes from individuals and churches. We receive no state or federal funding for the care of children. All gifts are tax-deductible and greatly appreciated.
PO Box 4196
Monroe, Louisiana 71211
7200 DeSiard Street
Monroe, Louisiana 71203
