MMHCS

Registration involves THE FOLLOWING steps:

Step 1 - Documents

Click on any of these panels or scroll down and select the 
"Adult Forms" tab.

Click on each filename listed and a .pdf 
document will open.
Download each form to your local drive then open using Adobe Acrobat Reader,
complete and submit it.

(A common error is to use your browser to edit the form. This may cause the form to behave erratically and may not properly activate form's signature and submission options)

Step 2 - Images

Select the "Identification Images" tab.
Registration requires you to provide an image of a valid identification card e.g. driver's lisence (front side only), passport or other state issued photo ID.

Using Health Insurance:
If you will be using health insurance, you will also need to provide a .jpg image of the front and back of the insurance card(s) sent to you by your health insurance provider.

Self-Pay
If you would prefer to Self-pay for services, please discuss cost with us and then fill out and submit the "Self-Pay Agreement" form found under  the "Miscellaneous Forms" tab

EAP
Please click on the:
Employee Assistance EAP tab below

Step 3 - Upload

Forms can be submitted electronically by 
clicking the 
"Upload Registration Materials" button below to 
manually attatche forms and 
send via email.

All registration materials must be submitted no less than two working days to allow time for processing

*Our forms allow you to submit them back to MMHCS.  For this to work correctly please download free Acrobat Reader (if needed) and make sure you "Trust Certificates" coming from MMHCS.

Check out the requirements for tele-therapy

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PLEASE CALL AND TALK WITH STAN mAKRINOS PRIOR TO SUBMITTING ANY DOCUMENTS

registration maTerials are due 48 hours prior to scheduled initial appointment

APPOINTMENTS without INITIAL registration maTerials will be rescheduled - NO EXCEPTIONS

Contact Us

You can have anything you want if you are willing to give up the belief that you cannot have it... -  Dr. Robert Anthony

registration maTerials are due 48 hours prior to scheduled initial appointment

Documents under
"Adult Forms" or "Identification Images"
are Mandatory and must be included.
If a client is a Minor, please select "Adolescent Forms" tab
and include the "Notice for Minors" Form

MANDATORY
01 Valid Photo ID (front)
02 Insurance Card (front)
03 Insurance Card (back)

All images must follow the .jpg image format only. 
Images may be sent as .jpg attachments to email or may be sent via phone-text. 
Please do not send image files via FAX, they will not be accepted.

If you are planning to utilize Employee Assistance Program (EAP) to fund your therapy, please be aware of the following:
1. Please obtain an EAP Authorization document from your EAP provider to initialize EAP services
2.  Services will be billed as EAP o​nly AFTER you have provided the EAP Authorization document.  Until that happens, billing will be routed to your Health Insurance provider.
3. EAP Authorization document  must contain a) Authorization #, b) Number of authorized sessions and c) Authorization Start and End Date.
Should you have any questions please ask us.

RECOMMENDED
01 Notice For Minors

Important - for ALL clients younger than 18 years old:
All clients younger than 18 years old need to be accompanied by legal guardian(s).
At least one legal guardian needs to remain present and available to the therapist during each session in case need arises.

All .pdf forms can be submitted directly from within the form by clicking the "Submit Form" button found at the  top-right of each opened form. Alternatively, click below to  manually upload forms as email attachments

Upload Registration Materials
Check out the requirements for tele-therapy

CONTACT FORM

Makrinos Mental Health Counseling Services, LLC
3268 Jefferson Avenue, Cincinnati OH 45220
Phone: 513-708-8188, Email: mmhcs@fioptics.com, FAX: 513-677-6624

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