Guiding Light Mental Health Services, LLC

Guiding Light Mental Health Services, LLC Send Message

Who would be receiving care?

Someone else

Your info

First name

Last name

Phone

Name you go by

Date of birth

Gender

State

Select the state you live in

Reason for care

What is the reason for seeking care?

Anxiety Depression Trauma Self-esteem Issues Other

Administrative

Inquiry reason

Billing & Payment

Insurance details

If you are covered under more than one insurance plan, please select both plans below. If you're insurance is not listed below, I do not accept your plan

BCBS UnitedHealthcare & UMR Aetna (commercial) WK Health Plus (Meritain/Aetna) Christus Health Cigna Carelon Behavioral Health Providence Health Plan Cigna EAP Telus Health EAP UnitedHealthcare EAP Anthem Expanded EAP Anthem Standard EAP Aetna EAP Lyra Health EAP Private Pay- No insurance

Client Preferences

Preferred appointment times

Office Hours: Monday-Thursday (9am-4:30pm). Closed Fridays. I do not currently have any consistent availability after 2:30pm.

Morning (9-11am) Lunch (12-2:30pm)

Preferred modality

In-person Telehealth

Is there anything that the practitioner needs to know?

For example: what you'd like to focus on, insurance or payment questions, etc.

Limited to 600 characters

For medical emergencies, contact your healthcare provider or call 911. For mental health crises, call or text 988.

By submitting this form, you agree to the processing of your sensitive personal information, which may include protected health information (PHI). This information may be viewed by team members in this practice. You also agree not to submit any payment information, including credit or debit card details, through this form.