Forms

To save time, please fill out the following forms before your first visit.

​

Adult Intake Form

Confidentiality Agreement

Professional Disclosure

Child Symptoms for Intake

Consent to Treatment

Consent to Use & Disclose Health Information

Child Intake Form

Fees & Payment

Kasandra Wheeler PLLC accepts several insurance plans including: BCBS, Aetna, MedCost, CBHA, and Out-of-Network.

Please contact Practice Manager/ Owner: Kasandra to go over individual insurance plans and billing questions.

​

Self-pay rates are $120 for your initial session and $100 for follow-up sessions.

​

Payments Accepted: Cash, All Credit Cards, FSA/HSA Cards

​

 

Resources

Reading Materials
Websites
Blogs
Worksheets & Downloads

  • 3 Surefire Strategies for Coping with Anxiety

​

​

DOWNLOAD FREE WORKSHEETS