Client Forms

Georgia Notice Form

Notice of Anisa Grantham, LPC, MAC/Rincon Recovery Resources Policies and Practices to
Protect the Privacy of Your Health Information

Read and Download

Patient Intake Form
Please fill out to the best of your ability and email back to us at anisa.grantham@gmail.com.

Fill Out Here

Confidentiality and Billing Disclosure

Information about our confidentialy and privacy, billing, payment, and missed appointment policies.

Read and Sign Here

Interaction with the Legal System

An agreement pertaining to legal system proceedings.

Read and Sign Here

Informed Consent for Telemental Health Services

Information on telemental health services and authorization for counseling.

Read and Sign Here
Contact Us

For any inquiries please contact us.

Rincon, GA
(912) 826-0918
anisa.grantham@gmail.com 
https://anisagrantham.com 

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