
Click on desired form to print, fill out and bring with you to your appointment.
Fill out and bring to your appointment for Mental Health Services.
Diagnostic Assessment Questionnaire
Fill out and bring to your appointment for Mental Health Services.
Fill out and bring to your appointment for Mental Health Services.
Fill out and bring to your appointment for Mental Health Services.
Fill out and bring to your appointment for Mental Health Services.
Fill out and bring to your appointment for Physical Care Services.
Click on desired file to print and keep for your records.
Insurances Accepted (Behavioral Health-Substance Use Treatment)
Must bring at time of visit
- Medicaid
- Medicare A & B
- CareSource
- Molina
- Buckeye
- United Health Care
- UHC Community
- Paramount-until 6/30/22
- Anthem (We don’t accept Federal plans)
- UMR
Insurances Accepted (Primary Care)
Must bring at time of visit
- Aetna
- Anthem
- Ambetter
- Buckeye Medicaid
- Caresource
- Cigna
- Humana – some plans (no Medicare Gold Plan)
- Medicaid
- Medicare Part B
- Molina
- United Healthcare Community plan – Commercial and Medicare
- Wellcare by Allwell