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Notification of Crisis Services

These services are available to you in the absence of Fairbanks Therapy Associates

Fairbanks Memorial Hospital ER

1650 Cowles Street, Fairbanks, AK 99701

907-458-5555

For evaluation or admission for medical and mental health emergencies

 

Interior Alaska Center for Non-Violent Living

907-452-7273

24-hour crisis line to address domestic violence and sexual assault crises.

 

Careline Crisis Intervention

907-452-4357

Connects to a national service for suicide prevention and other crises

 

Fairbanks Community Mental Health Center

907-452-1575

During office hours, telephone messages are checked frequently and routinely. All crisis calls will be

returned the same day. If you need assistance during a time when your therapist is not available, please

contact the appropriate resource immediately. Most often, clients do not require any of these additional services.

 

This is to inform you of the community resource available to you should the need arise.

Professional Disclosure Statement

Per 12 AAC 62.930, in the event that Fairbanks Therapy Associates treatment programs are discussed with other professionals, all clients’ confidential information will be maintained; and the name and the identify of all clients will be disclosed only in compliance with AS 08.29.200. This information is required by the Board of Professional Counselors which regulates all licensed professional counselors. Board of Professional Counselors Division of Corporations, Business & Professional Licensing P.O. Box 110806 | Juneau, AK | 99811-0806 Phone: (907) 465-2551

  • For ongoing therapy and group clients. We are still seeing clients via the telehealth program called VSee. Please download it onto your phone or other device before your appointment. You will recieve an invite from us in your email. Please accept it so we can call you at your appointment time.

  • Payments must be made online. Please click this link to make a payment:

  • To verify appointments please check your texts and emails.

  • Calls from our office might be coming from a (218) area code to protect privacy.

  • A Teletherapy ROI must be signed and returned before your appt. We have sent them to your email, we have them available in our LEAP mailbox at our office. You can sign, put in envelopes (ROIs and blank envelopes in our mailbox) and slide under door. We can also text you the form. If you cannot sign the form, you can Send us an email from your personal email that states the same info that is in the ROI below and send to LEAP@LEAPFbks.com.

  • Please email LEAP@LEAPFbks.com with any questions.

Intake: Adult Therapy

Sensory Processing List

Intake: Minor/Child

All Forms Must Be Filled Out and Submitted Before Your Appointment

FTA Financial Agreement/HIPPA Policies

Client Information Sheet

Consent to Treat a Minor

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