Administration
Insurance Information
Out of Network
- Aetna
- A & I Trust
- Blue Cross http://www.or.regence.com
- Cigna http://www.cigna.com
- Health Mgmt (BC)
- ODS http://www.odscompanies.com
- Providence Open Option http://www.providence.org
- Pacific Source http://www.pacificsource.com
- UMR (Fiserve) http://www.umr.com
Intake Information
Below are the intake forms necessary to schedule an evaluation or treatment session. Our office manager, can tell you which forms you'll need.
| Attachment | Size |
|---|---|
| Fee Schedule0412.pdf | 91.41 KB |
| Parent Questionnaire for Children.pdf | 154.89 KB |
| Evaluation Questionnaire for Adults.pdf | 137.58 KB |
| OMT Observation.pdf | 52.79 KB |
| Release of Information.pdf | 45.84 KB |
| Release of Information-Ed & Pro Purposes.pdf | 94.91 KB |
| Privacy Practices.pdf | 101.5 KB |
