Client Intake Forms

Client Demographic

Client Intake

Disclosure Statement

Authorization Release

Cancellation Policy

Accepted Insurance Plans

EEBPA/CBA, Geisinger, UMR, Mailhandlers
Anthem
BHS | Behavioral Health Systems
Behavioral Healthcare Program
Blue Cross
Blue Shield
BlueCross and BlueShield
Geisinger
Generations Advantage, US Family Healthplan
Harvard Pilgrim
HealthPartners of MN and WI
Healthplans Inc., United Behavioral Health/Optum
Horizon Healthcare
Maine Community Health Options
Martin's Point
Optum
TRICARE
UMR
UnitedHealthcare UHC | UBH
Out of Network

Qualifications

Years in Practice: 9 Years
License: Maine / CC462