top of page

Please complete ALL FOUR of the forms below prior to your first appointment. You must click "submit".

Please DO NOT complete these forms until you have an appointment.

New Patient Questionnaire

Confidentiality

Privacy Policy

Office Policies

Just F.Y.I. 

Social Media and Texting

Information You Have a Right to Know

USING INSURANCE BENEFITS

I am a participating provider (in-network) for the following plans:

  • MHN

    • Requires prior authorization. Contact your HR Department or Mental Health Unit

  • Kaiser Permanente

  • Medicare

  • Magellan (EAP only)

    • Requires prior authorization. Contact your HR Department or Mental Health Unit

  • Claremont

    • Requires prior authorization. Contact your HR Department or Mental Health Unit

 

If you don't have insurance, or have a high deductible or co-insurance, we can talk about an appropriate fee.

Teleheath Instructions and Policy

bottom of page