YOUR FIRST SESSIONI’m looking forward to meeting you! If this is your first session, please fill out the forms below and obtain preauthorization, if applicable, from your health plan. Click here to see a list of health plans I accept, including BlueCross BlueShield, Tufts, Harvard Pilgrim, Medicare, Cigna, and more.
BEFORE YOUR FIRST APPOINTMENT If you are coming in for an appointment, please print out and bring in the following completed forms (or fill out online and fax to 781-459-3058 or email to firstname.lastname@example.org).
- If you have another counselor or doctor you’d like me to communicate with, please fill out the Release of Information Form.
- Sport psychology clients should fill out the Sport Psychology Questionnaire and Basic Information forms only.
- If you will be using Harvard Pilgrim or United Healthcare/United Behavioral Health insurance, please fill out a Wellness Assessment, too.
Click on Pay Now below to save time by prepaying your copay or session fee with a credit or debit card. (Note: you do not need a PayPal account for this transaction. When you see the PayPal page and “Choose a way to pay,”select the bottom option, “Pay with a credit or debit card” if you don’t have a PayPal account.) Thank you!