RESOURCES

Below are useful resources to navigate our Practice and our Services including our Patient Ally Portal log on, instructional video and FAQs; access to our Forms as well as when and how to use them; in-network insurance and self-pay options and costs; and our policies and some supportive videos.

Didn’t find what you needed? Call our Patient Care Team, available Monday through Friday from 8:00 am to 5:00 pm at 850-389-8489, or submit a request for a team member to call you by clicking the button below and completing the online form.

Patient Portal


We have partnered with Patient Ally to provide a free, secure, confidential, and easy to use patient portal that enables our Clinical Team and Patient Care Team members to connect with our patients. Current and new patients can register, log in, and access messages as well as important documents regarding their services and treatment. While Patient Ally offers a variety of tools for patients to access and manage their personal health records, we are currently employing the messaging and documents features and will add more facets in the future.

Have questions? You can watch the quick 4-minute tutorial video below. Also, you can scroll down for answers to frequently asked questions. Need more help? Please contact Patient Ally at 1-888-747-4255 or via email, info@patientally.com.

 
 

Forms


New Patient Registration

Our Practice registration and fillable forms are sent (with an email notification) to patients once enrolled in Patient Ally, our practice management system’s patient portal. You can also download and complete your New Patient Information and the appropriate History form using the buttons below.

Fill Out Online

These digital fillable forms can be completed in your browser, by using Adobe Acrobat, or by using another PDF viewer, then printed, signed, and submitted to our Patient Care Team before your first appointment. If you complete forms within your browser, you must save it as a PDF and print directly from your browser in order to maintain your responses. We suggest using Google Chrome to complete and print your registration before adding your signature.

Print & Sign

If you prefer to complete all documents in paper form, please print the blank forms, completing them by hand including your signature, and submit them to our Patient Care Team. We require your registration documents be completed and submitted to our Team before an appointment will be scheduled.  


Insurance & Self Pay Options


Insurance

We are network providers for:

  • Tricare Prime & Tricare Select

  • Veterans Administration Community Care Network (Optum & TriWest Healthcare Alliance)

  • United Health Care (UHC), Optum & United Behavioral Health (UBH)

  • Aetna ASA PPO

Self-Pay

Rather pay for your treatment directly and not use private health insurance? In most cases, we can supply a superbill and/or visit statement (an itemized detail of services provided) which you can submit to your insurance company for reimbursement.

Typically insurance companies will not cover the cost of Executive Function Coaching so this service if fully self-pay.

Fees

Our self-pay rate is $275 for the initial clinical diagnostic evaluation and other costs can be found in the Service & Fee Schedule below.

Executive Function Coaching is billed as a package for the multiphase mental fitness training at $499.

Deductibles, co-insurance, shared costs, co-pays, and/or self-pay fees are due at the time of service and payment method is solidified during registration.

Policies & Helpful Videos

In addition to the forms and information above, you can review our Practice policies and watch some short, helpful videos from our PsychHub partner.

Let us know how
we can help.

 
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