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.

Just F.Y.I. 

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.