We're committed to helping you.
A new option for talk-therapy
These are some of the questions I would like to answer in the following video.
If you are at risk of harming yourself, you are not a candidate for telehealth therapy. Please go to the nearest hospital or call 911.
__1. Read and sign Self Pay
__2. Insurance question list.
__3. Fill out the 3 page Intake and Informed Consent Form.
__4. Read the HIPAA update.
__5. Sign the HIPAA receipt. .
__6. OPTIONAL. If you want information faxed to your primary care physician or psychiatrist fill out the PCP form.
__7. Include a copy of your Drivers License and Insurance Card (front and back).
1. Finish the check-off list below. Please be aware, if the paperwork is incomplete or we assess you are not a candidate for virtual therapy, we will notify you.
2. Email the completed paperwork to our secure fax at: email@example.com
3. Once all paperwork is completed, you will be sent an invitation to join our network. You will be instructed to set up your own account and will then be able to schedule your own appointments.
LET"S GET STARTED!
The Paper Trail (Checklist to be completed before we can begin.)
PLEASE SUBMIT YOUR PAPERWORK BEFORE SETTING AN APPOINTMENT!
Debra Brandt Counseling | 595 W. Granada Boulevard, Suite H, Ormond Beach, FL 32174 | Phone (386) 673-9800
PLEASE NOTE: MAKE SURE YOUR DEVICE IS FULLY CHARGED!