New Clients

Welcome! We're here to help.

If you would like us to verify your insurance benefits before you schedule an appointment, please fill out the form below and we will do our best to check your benefits. The insurance plans we are in network with are BCBS PPO, Aetna, United and Cigna. If you have an insurance plan not listed, some of our therapists offer sliding scale options.

Benefit Verification Form

Please fill out the form below and we will get back to you within one business day with your benefit coverage. Please note, insurance companies sometimes misquote benefits. Benefit checks done by New Hope Counseling are not guaranteed in accuracy. You are ultimately responsible for knowing what your plan covers. In the event that a benefit was misquoted, it is still your responsibility to pay your balance.

* Indicates required field

Client's Name *

First

Last

Client's Date of Birth *

Phone Number *

Email *

Please Select Your Insurance *

Primary Subscriber Name *

Primary Subscriber Date of Birth *

Insurance ID Number (include letter prefix) *

Group Number *

Customer Number on the Back of Your Card *

Additional Information *

Submit

To schedule an appointment

You can view available appointments and schedule an appointment through our online portal. Once you schedule an appointment, your therapist will approve the appointment and send you an email with further instructions. *Please note - Appointments cannot be scheduled within 24 hours of the requested time. Any appointments requested within 24 hours must be scheduled through your therapist or our scheduling specialist.*

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Welcome! We're here to help.

Benefit Verification Form

To schedule an appointment

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