INSURANCE

I am a provider for: 
Aetna
​MHN
United Behavioral Health (Optum)


​

FORMS for new clients
​client information, informed consent, and insurance information. Please print and complete, and bring to first session.
/uploads/6/6/1/9/66191513/private_practice_client_information_form.docx 
telehealth-informed consent
telehealth_informed_consent_form.pdf

Please print last page,  complete, and bring to first session. First pages are for your reference.
/uploads/6/6/1/9/66191513/private_practice_hipaa_and_acknowledgement.doc