New Client Insurance Benefit Check

Name (First & Last): *

We only accept out-of-pocket payments and BlueCross/BlueShield PPO insurance. Most insurance providers cover individual, couples and family therapy services, but check with your provider to confirm. Payment plans are available for services, and if you have 'out-of-network' benefits with a Non-BlueCross/BlueShield PPO provider our services may be covered by your insurance carrier. We can check your insurance benefits before your first appointment, please use the form below to see what might be covered.

Name (First & Last):

Insurance Phone:

Date of Birth:

Phone: *

Insurance Group #: *

What Type of Therapy are You Interested In?

Email: *

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Insurance Provider: *

Insurance ID # (Include any alpha prefix): *