SCHEDULING AND PROFESSIONAL FEES

We strive to provide a flexible schedule for you. Our services are available on weekdays and evenings by appointment. While many insurance providers reimburse for mental health services, each policy varies. We will assit you in determining your insurance / HMO coverage. In addition, MasterCard and VISA are accepted for your convenience. Individuals with Medicaid can request services at NorServ by calling their managed care number for authorization.

For further information or to schedule an appointment, contact (810) 329-4798.

*ALL INQUIRIES ARE CONFIDENTIAL*

NORSERV FORMS

Intake Questionnaire .......................... CLICK HERE TO DOWNLOAD

Release of Information ....................... CLICK HERE TO DOWNLOAD

Billing & Insurance Policy .................... CLICK HERE TO DOWNLOAD

One Time Authorization ...................... CLICK HERE TO DOWNLOAD

Procedure Guidelines & Orientation ...... CLICK HERE TO DOWNLOAD

Consent to Services ........................... CLICK HERE TO DOWNLOAD

Forms may be downloaded, completed and brought to your first session. Please DO NOT email these documents as attachments - they contain your protected health information.

*ALL DOCUMENTS REQUIRE ADOBE ACROBAT READER*