Forms/Insurance/Resources

Forms

Our practice forms are sent (with an email notification) to patients once enrolled in Patient Ally, our practice management system’s patient portal. You can also download and complete your Patient Registration Paperwork and the appropriate History forms. These forms can be completed in your browser, by using Adobe Acrobat, or by using another PDF viewer, then printed, signed and submitted to our Patient Care Team before your first appointment. You can also print and complete the forms entirely by hand.

Please note that if the forms are completed within your browser, the form must be saved as a PDF and printed directly from your browser in order to maintain your responses. We suggest using Google Chrome to complete and print your paperwork before adding your signature. 

Patient Paperwork

Adult History (ages 19+)

Child / Teen History (ages 1 – 18)

Authorization to Release Confidential Information

Insurance Accepted & Self-Pay

We are network providers for:

  • Tricare Prime & Tricare Select
  • Veterans Administration Community Care Network (Optum & TriWest Healthcare Alliance)
  • United Health Care (UHC), Optum & United Behavioral Health (UBH)
  • Aetna ASA PPO

We also accept self-pay patients who choose to pay for their treatment directly rather than using private health insurance.

Resources

In addition to the forms above, review our practice policies and check out some short but helpful videos from our PsychHub partner.

Collateral Visits Questions and Answers

Privacy Policy

Internet and Online Policy

PsychHub Video – Mental Heath Treatment: 5 Things Your Therapist Wants You to Know

PsychHub Video – Asking For Help With Your Mental Health

PsychHub Video – The Connection Between Mental and Physical Health

PsychHub Video – How Does Cognitive Behavior Therapy Work?

PsychHub Video – Mental Healthcare Online: Options in Telehealth

PsychHub Video – Eye Movement Desensitization Reprocessing (EMDR)