Collaborative Change
Patient Information
1
Referral Form
First step in accessing our services is completing our online referral form. Anyone can complete this form. Please make sure to upload the insurance cards at the bottom. If a specific therapist is requested please put their name on the form. If the referral source would like to be kept updated on the progress of the referral please add their email. We do not provide services to anyone under the age of 10. Unfortunately we do not accept Tricare or Cigna insurance.
3
Connection with Therapist
24-48 business hours after the intake and consent forms are signed we will verify insurance will cover our services and update the patient on any fees. The patient will be connected via email with a therapist that meets their needs and availability once all fees are agreed upon if any are due. All fees for services are due at the time of service.
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