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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

Medicare and most Advantage Plans

Pay with a program

Optum Live & Work Well (EAP)

Pay out-of-pocket

$150 per session

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