Let's make sure I am a good fit before we talk: *

I am aware that Mountain Psychiatry does not accept insurance and is therefore "private pay."

I have reviewed the clinic fees, understand the cost of the assessment, and that appointments range in cost to $600.

I do not have Medicaid. (By law, only contracted providers can see medicaid recipients).

I understand that clients need to be located in Colorado, California, or Virginia during virtual appointments due to licensing laws.

Name *

First Name

Last Name

Phone *

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