Intake Packets
Insurance Clients
(Not UHC)
Follow these steps for each person who will attend and is using insurance that is not United Health Care (UHC) —
Notices
Read these Notices, which includes our Payment Policy, Consent to Treat, Privacy Policy and Fees.
Intake Packets
Download, print and fill out one of these for each person present —
Return Packets to Us
After you fill out the intake —
- Scan and Email packet to us,
- Or fax packet to us at 602-674-5701,
- Or bring the completed packet with you to the first session.
If a child is attending and you are not the child's parent, you must show legal proof that you can make medical decisions for the child.