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Please complete all required fields!
You will be asked to provide insurance info on the following pages. Please note that we do not accept medicaid.
Primary Insurance Information
We accept the following forms of insurance: BCBS, Cigna, ComPsych, Consumer's Choice, Coventry, Magellan, Medcost, Medicare, MHNet, Multiplan, Tricare/Tricare Prime, and United Behavioral Health/United Health Care. We do not accept Medicaid.
All fields must be filled out. Please write "NA" in each field if you do not have insurance.
Secondary Insurance (if applicable)
Please let us know how and when to contact you.
In order to finalize the appointment, you will need to provide us with a Visa or MasterCard number.
We won't use this number or charge anything before the appointment and we will delete it at your first appointment, but if you don't show up or give us a 24 hour notice, you will be charged $65.
Once you have completed the online form here, print and fill out these forms. Bring them with you to your appointment in order to speed up your wait time.
Check out these helpful links for more information on many types of mental health issues and prescription drugs.
If you have questions about our office orwhether we take your insurance,give us a call at (843)735-6799.