Insurance Info & Helpful Forms

At this time, I am paneled with the following insurance companies:

Anthem Blue Cross and Blue Shield
AETNA
Harvard Pilgrim
Martins Point
Wellsense

For those who do not wish to use their insurance, but cannot afford to pay in full, I do offer a sliding fee. Please do not hesitate to contact me with questions about insurance or payment for services.

When you come in for your first appointment, I ask that you complete a Client Information form. If you wish, you may complete this form in advance of your appointment. Please do not sign this form prior to our first meeting when we will review my Notice to Clients and Consent Agreement.

If you have any questions about which version to complete, please feel free to contact me.

Client Information Form: (please complete the form that is appropriate to you)

Adult individual

Adult couple

Minor individual

 


1039 Islington Street, Suite 13
Portsmouth, NH 03801
Phone: (603) 828-6554 | Fax: (603) 766-5322
[email protected]


Licensed Clinical Mental Health Counselor