Please download, print and fill out all 4 forms below prior to your first appointment. Attach a copy of your insurance card and bring the entire packet with you when you come for your scheduled office visit. Please call (703) 629-9116 if you have any questions.
Please verify your health insurance before your first visit.
Accepted insurance plans include: Anthem, Aetna, Care First Blue Cross/Blue Shield (HMO and PPO), Cigna, Comp Psych, Medicaid (Anthem Healthkeepers)
** All new clients: Please download the forms and call for an appointment. Online appointment scheduling is for returning clients only. Thank you.
Required Intake Forms
- Client Intake Form (Adult)
- Client Intake Form (Child)
- Client Payment Agreement
- Financial Policy Statement
- Upload Your Insurance
- Privacy Notice Form
- Cancellation Policy
Other As Needed Forms
- Release of Information
- Psychological Testing
- Depression Anxiety Stress Scales (DASS)
- Legal Fee Schedule
- Private pay: Initial fee $130.00, then $110.00/session. Phone session if needed, is $65 for a 30 minute session.
- Insurance: Patient balance will depend on your co-payment/co-insurance or if you have a deductible.
- Forms of Payment: MasterCard, Visa, Discover and personal checks (Made payable to: Battlefield Counseling Centers or Faith James LLC).