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New Patient Registration Form

By completing this form it will make scheduling your first appointment faster and easier.  We will contact you within 48 hours after sending this form.  If we can find a good fit and therapist appointment that works, we will send you additional forms thru our portal.  It is important to complete your intake forms before that first appointment.  

Insurance
Additional Preferences
Scheduling Availabilty
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Renew Counseling, LLC

Oldham County Office

2202 Commerce Parkway

Suite E

LaGrange KY 40031-8730

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Preston Office

3027 Preston Hwy

Louisville KY 40217-1716

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Middletown Office

802 Stone Creek Parkway,

Suite 1A

Louisville KY 40223-5393

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Phone 502.653.7211    Fax 502.416.0723 

St. Mathew's Office

214 Breckenridge Lane,

Suite 114 & 214

Louisville KY 40207-3868

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