Please print and fill out the following forms and bring to your first session. If treatment is for an individual over 18 and not living at home, you do not need to fill out the family questionnaire form.
Additonal items to bring to first session; copy of front and back of insurance card, name and address of primary care physician, payment.
You are responsible for contacting your insurance company to make sure you do not need an authorization, if you do you will ask for the authorization number and bring it to your first session. You will also confirm, with your insurance company, what your co-pay is for mental health services (at times this is different than other medical co-pays), and if you have a deductible. You will also need to confirm your mental health coverage and if it is covered by the same company as your medical insurance; many insurance companies utilize 'carve out' services from mental health which is a through a different provider (like a separate dental plan) and you many not even realize this. Also make sure that you inform your therapist if you, or your child, has any secondary or additional insurance even if you didn't intend to use it, this may result in benefits being denied if the proper insurance is not utilized.
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