top of page
Intake forms
Click on this PDF icon and open the fillable intake forms in Acrobat Reader. Or you can choose to print the forms, fill them out, and then email them to me at
Pay with insurance Kaiser - In Network
United Heathcare
Aetna
Cigna
Blue Shield
Anthem
Original Medicare
Pay with a program
Optum Live & Work Well (EAP)
​
Pay out-of-pocket
$125 per session
bottom of page