INSURANCE AND FORMS
INSURANCE AND PAYMENT
Your insurance information will be reviewed prior to your initial session. You are responsible for your copay during each visit. Cash, Credit Card, or check are accepted for payment at the time of service.
United Behavioral Health/Optum
Iowa Total Care
New Patient (Required)
Group Member Form(s)
COUPLES QUESTIONAIRE & CONSENT
Forms as Needed
RELEASE OF INFORMATION ( as needed)
We understand that sometimes that clients are unable to make a scheduled appointment due to unforeseen circumstances. However, we require patients to reschedule or cancel appointments within 24 hours of a scheduled visit.
If you are a no show or fail to reschedule/cancel an appointment without giving the 24 hours notice a $50.00 charge will be applied to the card on file for each missed appointment