For each new psychotherapy client who is not affiliated with Integral Care, please fill-out this simple intake form.
You’ll be taken to a page powered by Storm Medical Billing and Medform, which is a secure and encrypted form powered by a HIPAA compliant software.
You’ll be taken to a page powered by Storm Medical Billing and Medform, which is a secure and encrypted form powered by a HIPAA compliant software.
For the first field, please include the name of the Counselor/Therapist that you are requesting to see so that our medical billing team connects you with the correct clinician.
For clients who prefer to manually fill out the form and fax it to us, you can print it out and fax it to (888) 508-2108.
For clients who prefer to manually fill out the form and fax it to us, you can print it out and fax it to (888) 508-2108.
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