New Patient Information
Thank you for selecting our office for your mental health care. There are 5 forms that must be completed before scheduling your initial appointments. The quickest way to complete the forms is through our patient portal. Please call the office to register. You can also complete these forms from our website (select Required Forms on the left). Forms completed from our website can be returned to us either by mail, email, or fax. Because we schedule multiple 55-minute appointments for the initial evaluation, a debit/credit card is required to secure the appointment times and $200 will be "pre-authorized" but not charged to your card at the time of scheduling. If you miss your initial appointment or cancel without 24 hour notice, a $200 missed appointment fee will be "charged" to your card and all other scheduled appointments will be cancelled (see missed appointment policy and office policy).
Please don’t hesitate to call our office with any questions you may have.
SEE PATIENT PORTAL INFORMATION tab for more information about our portal.
Our providers have chosen not to contract with any insurance plans which includes Medicare (see below), Medicaid and Tricare. Please know your Out of Network insurance coverage before scheduling appointments. At this time, we do not offer fee reductions, payment plans or single case agreements with your insurance company. We will collect payment, in full, from you at the time of each visit.
MEDICARE PATIENTS: Please notify us if you have Medicare.
40.5 -When a Physician or Practitioner Opts Out of Medicare
(Rev. 92; Issued: 06-27-08; Effective/Implementation Date: 09-29-08)
When a physician/practitioner opts out of Medicare, Medicare covers no services provided by that individual and no Medicare payment can be made to that physician or practitioner directly or on a capitated basis. Additionally, no Medicare payment may be made to a beneficiary for items or services provided directly by a physician or practitioner who has opted out of the program.