Individual Minors 12-18 Years of Age

In Colorado, minors (12 years of age and older) may consent to their own mental health services without the consent of their parent/legal guardian. In these situations, the mental health professional shall engage the minor in a discussion about the importance of involving and notifying the minor's parent or legal guardian and shall encourage notification to help support the minor's care and treatment.

In support of the applicable statutes, BFCW does ask that all minors 12 years of age, and older, sign their own consent for services and that they complete the associated assessments and questionnaires. If you believe your child is unable to compete this task, please use the designated space below to describe the circumstances. We will do our best to support.

In the State of Nevada, one parent may consent to behavioral health services if they are actively in a relationship/cohabiting/married with the other parent AND they attest that both parties (who have equal decision making) are in agreement that the minor attend counseling.

If the parties are no longer together/divorced it is mandatory that both parents consent to the treatment of a minor unless there is legal documentation that states that one person has sole medical decision making power; we will require the document to upload it to the client's file.

Please complete each of the following steps to begin services:
1. Click HERE to schedule a phone appointment with our Referrals Team
2. Fill out the form below (form is required for the meeting with the Referrals Team)
3. Speak with our Referrals Team to verify eligibility, complete your chart setup & schedule an Initial Intake with your provider.
4. Begin on your path to growth & wellness!

To begin services, please enter the following information*:

Please confirm the services being requested: *

Individual Counseling 18+ Individual Counseling 12-17 Years of Age Individual Counseling Under the Age of 12 Couples Counseling Family Counseling

* Indicates required field

Name of the Person Receiving Services *

First

Last

Please provide the minor's email. They may use their parents email, if they do not have their own, but they must sign/complete their own paperwork. *

Phone Number *

Do we have consent to make contact via email? *

Location Preference *

Type of Payor *

Type of Insurance (if applicable) *

Name of Insured *

Member ID/EAP Authorization Number *

Date of Birth of the Person Receiving Services *

Preference *

Appointment Day Preference *

Appointment Time Preference *

Are you looking for an LGBTQIA+ affirming/ally clinician? *

Are you a previous client of Barber Family Counseling & Wellness? If so, who did you used to work with? Would you prefer to work with them again if there is an opening? *

Is there a specific clinician you would prefer/have been referred to work with? *

Submit

*By filling out this form, you are consenting to the use of electronic communication. If you do not consent to the use of electronic communication, you may also call our office to begin services at (866) 644-6131. Please note that our phone line hours are limited at this time to Monday through Thursday. Voicemails left will be returned within 5 business days.

Locations

Barnes Rd., Colorado Springs, CO
4775 Barnes Rd. Ste L
Colorado Springs, CO 80917

COMING SOON!
Briargate Blvd., Colorado Springs, CO
3475 Briargate Blvd. Ste 201
Colorado Springs, CO 80920

Las Vegas, NV
1771 E Flamingo , Ste 220-B (Bldg B)
Las Vegas, NV 89119

Phone: (866) 644-6131
Billing Questions: (866) 644-6131 ext 701
Fax: (719) 434-9615
wellness@barberfamilycounseling.com

Appointments available week days, evenings and weekends.

Our phone lines are monitored Monday - Thursday, from 11am-3pm for faster methods of contact, please use the following resources:
To inquire about or to begin services: Please click here.
For general Inquiries: Please click here.
For billing Inquiries: Please click here.

If you or someone you know is in crisis, call 911, go to the nearest emergency room, or call 1-800-273-TALK (8255) to reach a 24-hour crisis center.

You matter and you are never alone.

YOUR CART

To begin services, please enter the following information*:

Locations