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    • Domestic Violence
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    • Information Form CAADCs
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Bee Marie LLC

Bee Marie LLCBee Marie LLCBee Marie LLC

Health Insurance MH/SUD / Couples / Family Counseling

Information Form

Please complete this form. Intake forms will be sent to your email to complete before your first session. Thank you for booking with us. 


For more information, contact us at (810) 922-7628 or email: info@beemariellc.com




I understand the Individual MH/SUD Therapy /Couples / Family Counseling services offered by Bee Marie LLC will  be billed to my health insurance.  I understand that my insurance will be billed by a 3rd party appearing on my health insurance statements as Grace Counseling Services.  I understand that I am responsible for any and all co-pays, co-insurance and deductibles.  I agree to complete all requested forms including client history,  informed consent, notice of privacy practices, various screening tools and other information as requested.  For more information, call/text or email your questions to 810.922.7628 or info@beemariellc.com. Please answer yes or no in the final box on the form.


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