COMPLETE FORMS, SCROLL DOWN TO MAKE APPOINTMENT AND PAYMENT
Your appointment will be cancelled without completed forms.
NO OTHER TIMES ARE OFFERED PLEASE SCHEDULE ONLINE AND PAY
REQUIRED FORMS FOR SERVICES
Click to Complete Before Appointment
STEP ONE: CONSENT FOR SERVICES & PRIVACY NOTICE
REQUIRED WITH STEP ONE IF APPLICABLE:
DOMESTIC VIOLENCE ANGER MANAGEMENT ENROLLMENT AGREEMENT
STEP TWO: INTAKE QUESTIONNAIRE FOR MY ASSESSMENT APPOINTMENT
Our Services
Sat
5 hr 30 min
90 US dollarsSat
2 hr
70 US dollars
Sat
2 hr
Prices Vary
SLIDING SCALE APPLICATION REQUEST
Income Information Will Be Requested for Verification.
If you are eligible for Indiana Medicaid a provider will assist you with the application.