Required Forms:
We cannot process your intake paperwork until we received all of the required forms and a faxed copy of your insurance card and picture ID. Your signature is required on all fillable forms.
The Lacey clinic does not provide crisis intervention services and does not place clients who are in crisis or having thoughts of suicide on our wait list. If you are having thoughts of suicide or seeking crisis services for other reasons, please stop now and call the Thurston County Crisis Line at 360-586-2800, go to the Emergency Room, or contact your insurance provider for a referral to local area crisis services.
After completing the fillable forms, please fax a copy of your photo ID and insurance card to (360) 539-1715 for the Lacey Clinic or to (360) 846-1722 for the Longview Clinic. You may also attach digital copies to your Financial Intake Form. Insurance cards and other confidential information will not be accepted via email as this is not a secure method of transmission. Once we have all forms and have verified your insurance coverage, we will call you to schedule an initial assessment.
Notice: Due to Washington health care laws, the ROI form should be completed by clients age 13 and up if a parent or other party will need to communicate with us about scheduling or other information.
