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"Time to experience what is around you at any given time"

Telehealth

Out of Pocket Pay

Individual sessions 45-60 minutes.......120.00

Pack of 4 sessions 45-60 minutes .......400.00

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Insurances That Are Taken

Medicaid

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Please Read

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How to Fill In Forms

1.) Click on form, it will bring you to another page

2.) Click fill a copy in right hand corner

3.) Click fill a copy (only you) for copy type and scroll down to bottom of page and click fill copy
4.) Click i agree to use electronic records and signature, then click let's do this!
5.) After filling out form hit finalize in top right corner

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And you are done!

Intake Forms

*Please fill out forms after initial consultation*

Consent for Evaluation Form
Patient Information Form
Dr. Orders request Form
Change of Provider Form
Notice of Privacy Practice Acknowledgment Form
Teletherapy Consent Concise
Teletherapy Consent Extended
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