Intake Paperwork

Please use the portal intake forms or fill out your intake paperwork with the link provided below before you arrive at our office, and present to therapist at your intake appointment. If you are attending your session virtually, you will need to scan (or use 'mark up' or other digital signature options) and return to your therapist before they can have a session with you.

Please send a photo of your insurance card (front & back)

and your driver's license so we can verify your insurance at least 2 business days before your appointment through the portal link that is HIPAA compliant.

If not provided, you may be charged in full for the session type provided, and that amount may be applied as a credit once insurance is processed (about 30-45 days processing time).

Forms and Ins./DL photo can be sent to sheri@kyhopecounseling.com , please include

the therapist's name you are seeing.

Menu / Price List

Payments We Accept

Limited insurance and cash/credit card

Medicaid

Anthem

Aetna

Humana

United Healthcare

Commercial Insurance

Commercial Ins. usually has a co-pay and possibly a deductible you may have to meet. We will need to verify specific plan information.

Anthem

Humana

Humana Caresource

UCH

United Healthcare/Optium

Aetna

Cigna

Private Pay

We will take cash, FSA cards, credit cards, and checks for services and a good faith estimate will be provided

Credit Cards

We use a phone app (IvyPay) that the therapist will text you a link to. To charge your card (FSA, HSA, MC, VISA), you will enter the card number and the therapist will not see your card, this is a secure platform and HIPAA compliant. We charge 3% processing fee on the amount charged to your card. We also will ask to keep a card on file for our records to process in case of no-shows, rescheduling fees, or late cancels.

Subject to change. If insurance information is not provided two (2) business days before appointment you will be responsible for the cash price of the appointment.