We are committed to your privacy. Do not include confidential or private information regarding your health condition in this form or any other form found on this website.This form is for general questions or messages to the practitioner.To schedule an individual, group, child, couples, marriage or family therapy appointment or to obtain additional information about any of these counseling services, please fill out the form below and include your request or give us a call.
Partners, spouses and family members may schedule for a loved one provided an active payment method is given at first contact.
|Payment options: ALL CLIENTS are responsible for understanding and adhering to their HC Insurance policy along with the obligations that come with them. Debit and major credit cards are accepted, CHIME & some Health Savings Accounts are not. Please note an active
Debit/Credit card is required to schedule your first Intake appointment. Receipts will be sent via email provided. Payments are due at time of service. All services rendered in part or whole are non-refundable including those associated with the use of HC Insurance. An active payment method on file is our office policy and a requirement for continuation of service.
NOTE: We are an expanding community service that has committed the time to contract with as many Insurance panels as possible. This was done so as to offer our services to the general public. Money was not the major factor in this decision. Being as transparent as possible, we strongly encourage potential clients to access the information on our website in order to minimize any expectation gaps that may arise during your first appointment or those after. Compliance of our office policies and Information requests are a requirement for service.
Dispute Policy: if you choose to dispute a valid MBT charge with your financial institution, your Insurance carrier will be notified. Mind Body Therapeutics will not be held responsible for any possible actions taken against the policy subscriber, or one of its beneficiaries afterwards or in the future by a contracted panel. In addition, you will also be held responsible for administrative and collections related charges by a third party.
* Important Scheduling Notice: If you are currently in the deductible phase of your policy, the practice will be required to secure 70% of your contracted payment in order to be added to the clinical session schedule. If you fail to show to your scheduled Intake appointment that amount will be charged in order to cover your time slot. After completing the Intake session this amount will be applied towards your account. Unfortunately, we cannot allow any exceptions!
* Exclusive Telehealth Requests: All requests will be reviewed at first point of contact. ALL Intake forms including a Telehealth Payment Agreement will need to be completed and signed prior to being added to our clinical session schedule.
Cancellation Policy: Clients, their partners and their dependents are responsible for any missed, no show or same day cancellations. Reminder emails are sent out prior to your scheduled session. If you fail to show up to your scheduled appointment and have not notified us at least 36 hours in advance, you will be charged a $75 cancellation fee regardless if utilizing health insurance or any EAP benefits. If you fail to provide an active method of payment at time of service your insurance company will be notified and additional actions may be taken against your insurance policy.
We are a professional group practice. As such, our staff members, psychologists, therapists and counselors take your time and theirs seriously.
We ask that you please be mindful and responsible as we are at service for you!
Thank you very much!
COVID19 Isolation, Anxiety and Depression
Mental Health Counseling