Forms & Insurance

Below are some common forms to help you get prepared for your visit or to do self evaluations as directed by our physicians.

 

Please click on the appropriate form, download and fill them out to return them to jess@mountainviewpsychology.com or bring them to the office at the time of your next visit.

New Patient Forms:

> Adult Intake Paperwork
*Information required.
> Child Intake Paperwork
*Information required.
> Bariatric Intake Paperwork
*Information required.
> Consent for Telehealth/Virtual Services
*Information required.
> Credit Card Authorization Form
*Information required.
> Consent/Release of Information Form
*Information required.

Health plans which we accept:

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CHAMPVA

Not covered by any of these plans? Contact us and we will find the best solution to suit you.