Book An Appointment Have questions or ready to start your mental health journey? Use the form below—we’re here to help. Please enable JavaScript in your browser to complete this form. - Step 1 of 2Full Name *EmailPhone NumberService Interested In *Anxiety DisordersAnxiety DisordersDepressive DisordersNeurodevelopmental DisordersSubstance Use and Alcohol Addiction DisordersInsomnia and Sleep-Wake DisordersPost-Traumatic Stress and Adjustment DisordersObsessive-Compulsive Disorder (OCD)Bipolar and Schizoaffective DisorderPsychotic DisordersDate / Time *DateTimeIntake Appointment Saturday Hours: 10:00 AM – 3:00 PM NextMethod of PaymentInsuranceCashInsurance Provider *AetnaAetnaAetna-MedicareAll SaversAnthemAvMedBlue CrossBlue Shield (MHSA) / MagellanCarelon Behavioral Health (Commercial)CignaEvernorthGolden RuleHarvard Pilgrim / UnitedHealthcareHumana-MedicareHumana-Dual (Medicare & Medicaid)L.A. Care CoveredL.A. Care Covered DirectL.A. Care Covered PASC-SEIUOptumOptum Health – Complex Medical ConditionOscarOxfordScripps Health PlanSharp Health PlanSurest (formerly Bind)Turf Health / CignaUnited Medical ResourcesUnitedHealthcare Life InsuranceUnitedHealthcare Shared ServicesUnitedHealthcare Student ResourcesUnitedHealthcare / OptumUnitedHealthcare / Optum-MedicareInsurance Member ID *Additional Message (Optional)Submit IS IT URGENT? Please Call 916-430-7104
