REQUIRED:

new client information form

Please Note: we are currently experiencing a high demand for our services. Please be patient with us until we can get back to you. We will contact you within 2-4 days from the date you submit forms to begin the scheduling process. We consider all location and therapist requests but may need to recommend other therapists at other locations if your requested therapist(s) is/are not available. Thank you for your understanding. 

Here are some helpful hints to make this process go smoothly: 
 
1. Complete the “Client Information Form”. This form will help us understand your current needs and help us match you with the best therapist available.  Once received, our Intake Department will reach out to discuss your options.   

2. Once confirmed, we will send you a “Welcome Email” that will allow you to set up a Portal Account to complete the rest of your paperwork and consent forms.  Please provide us with as many details about your symptoms and needs when completing the portal forms.  Once inside the portal, completing the forms will take about 15 minutes.  Please be ready to upload images of the front and back of your insurance cards, and/or your EAP authorization.  You will also be able to save a credit card to your file that can be used to process any copays you may have. 

3. Once all forms are completed, our Intake Department will confirm your appointment with you by either email or text.  Our Intake department will send you our Client Handbook which provides further information detailing the services we provide, policies specific to cancellation, communication, confidentiality; client's rights, and about our compliance with HIPAA. 

4. Before completing our forms, contact your health insurance company and ask them about your benefits. What is your copay? Does your medical deductible need to be met before your insurance will help pay for services? Depending on your coverage, having to meet a deductible first can mean a difference of a $25-30.00/copay or $100.00-125.00/copay cost. 

5. Couples Therapy Sessions are not considered a medical necessity. Therefore, many health insurance companies do not cover couples' therapy. Couples therapy is $125 per session Private Pay. It's important to know that if an individual is having mental health issues because of relationship distress, the individual can become a client and do individual counseling and insurance will cover the cost of the sessions. Please know that you can allow other individuals to join your therapy sessions to address issues related to your relationship or any other matters that you need help addressing. 

6. We see clients aged 12 and up. If you have a child aged under the age of 16, we will consider placement after speaking with you further regarding your child's needs; do not fill out any paperwork until you have spoken to us. We have a very limited number of staff who can work with ages younger than 16. Please note: we are not a crisis center. If your child needs immediate help, please reach out to Nationwide Children's Hospital, Buckeye Ranch, Directions for Youth, Concord Counseling, or NYAP: National Youth Advocate Program. 
 
7. We are no longer accepting the following insurances: Molina, Beacon Health Options, UBH Medicare, Medigold, or Ohio PPO. 

 8. Please note: secondary insurances do not always automatically pay their part when we bill them. If a secondary insurance does not pay, the client is responsible for the remaining copay amount. 

 9. We are currently not accepting Anthem EAP or Optum UBH EAP insurances. We have very limited availability for placing EAP clients. The more flexibility you have in your schedule helps. Using your health insurance instead of an EAP plan can help, as we have a limited number of EAP providers. Please ensure that we receive EAP authorization prior to completing our Intake paperwork. 
 
10. The majority of our available session times are between 9am and 5pm. If you are flexible in your schedule, you will likely get an appointment sooner. Most therapists' evening sessions are booked for several months, but as clients complete their treatment, their evening time slots may open up for new clients to take. Please be patient about what time slots are available. 

11. If you schedule an appointment and cancel less than 24hrs in advance, you will be charged a $50 Missed Appointment Fee. You will not be rescheduled for future sessions until that fee is paid. Please be considerate of our therapists' schedules and the needs of other clients who are waiting for a time slot to open up with their therapist by canceling any appointments with more than 24 hours notice. If you are using an insurance where we can't charge you a missed appointment fee, then after 2 missed appointments, your therapist may refer you to another agency that can better meet your individual needs.