Online Balance Payment
This form will be used to pay your existing balance.
Psychotherapy Telehealth Informed Consent
Medication & Prior Authorization
Please open the link below and fill out the form. Your request is sent directly to your provider.
If your insurance company requires a prior authorization before they will approve a prescription, they will often take 72 hours to process the P.A. Your pharmacy will receive a notification when the PA has been approved, If your medication was not approved, our office will receive a fax to that effect and you will be asked to make an appointment to discuss other medication options.