Forms & Downloads

A compilation of important forms and downloads are listed for convenient download

Consent Forms

Client Handbook

Parents and Guardians may complete the Therapy/Psychiatry consent forms for their Child/Adolescent prior to arriving to the office in order to save time.

Clients may complete the Therapy/Psychiatry consent forms prior to arriving to the office in order to save time.

Parents and Guardians may complete the PRP consent forms for their Child/Adolescent prior to arriving to the office in order to save time.

Clients may complete the PRP Consent Forms prior to arriving to the office in order to save time.

Clients participating in Telehealth services must complete the Telehealth Consent Form prior to starting virtual visits.

Please return the completed Telehealth Consent Form to your provider or the administrative staff.

Need us to collaborate with a family member, lawyer, or previous provider?

Please return the completed Blank Release Form to your provider or the administrative staff.

Clients are required to complete the annual consent forms at the beginning of each year.

Please return the completed Annual Consent Forms to your provider or the administrative staff.

Referral Forms

The therapy referral form  is for clients who are requesting individual, group, couples and/or family therapy services. 

The Psychiatric Rehabilitation Program (PRP) referral form is for clients who are active in therapy and need additional support. The Medical Necessity Criteria Form is also required to be completed along with the PRP Referral Form. Both forms must be completed by a Licensed  Therapist of Licensed Social Worker. *Please  note: This program is only available for clients who have Medicaid.

The Psychiatry Referral Form is to be completed by a Licensed Therapist, Licensed  Social Worker, or Primary Care Physician. Clients must be in ongoing therapy in order to receive psychiatric services.

Clients may be paired with a therapist here at ITS if they do not have a provider.

Additional Forms

Therapy Verification Form for Psychiatric Services/Medication Management

All clients receiving psychiatric services/medication management by an ITS psychiatrist or psychiatric nurse practitioner, must be active in psychotherapy.

Clients receiving therapy outside of ITS must have their licensed provider complete and return the Therapy Verification Form within seven (7) business days of their upcoming appointment. Failure to return the completed form may result in your appointment being cancelled.

Application for Sliding Scale Fee Services

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At Innovative Therapeutic Services we strive to provide the best mental health services by recognizing the unique qualities of each individual and focusing on their attributes within.
Innovative Therapeutic Services is MBE Certified

Laurel Location

14440 Cherry Lane Court
Suite 208
Laurel, MD 20707

Phone: +1 301-604-1458
Fax: +1 301-604-1459
Email: LTHAI@innovativetherapy.org

COVID-19 Hours of Operation:
Monday - Friday: 9:00 AM to 5:30 PM (Virtual Sessions & Support)

Saturday: CLOSED

Sunday: CLOSED

Normal Hours of Operation:
Monday - Thursday: 9:00 AM to 8:00 PM
Friday: 9:00 am to 7:00 PM
Saturday: 9:00 AM to 2:00 PM
Sunday: CLOSED

Hagerstown Location

20 W Washington Street
Suite 503
Hagerstown, MD 21740

Phone: +1 301-393-3949
Fax: +1 301-745-3482
Email: STERRY@innovativetherapy.org

COVID-19 Hours of Operation:
Monday - Friday: 9:00 AM to 5:30 PM
(Virtual Sessions & Support)

Saturday: CLOSED

Sunday: CLOSED

Normal Hours of Operation:
Monday - Friday: 9:00 AM to 6:00 PM
Saturday: CLOSED
Sunday: CLOSED

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No one will be denied access due to inability to pay. There is a discounted/sliding fee schedule available.