Clarkston Family Therapists

Unlike other private practices, our clients do not have to submit their own paperwork to the insurance company. We have staff that will facilitate the billing process, answer questions you may have, and attempt to resolve issues regarding processing your claim.
If any client finds we are not on their insurance plan we may attempt to become a panel provider.
We do not accept Medicaid.

Please make sure to call your EAP prior to your first appointment. Authorizations and/or paperwork are required at your initial visit.

For those clients that do not have insurance or choose not to use their coverage, private pay options are available.

We accept checks, Visa, Master Card, Discover, American Express and Health Spending Accounts (HSA). All copayments are due at time of service.

While we understand emergencies do arise, a 24 hour cancellation notice is preferred. Without notification, a “no show” fee may be applied.

Clarkston Family Therapists, LLC complies with federal and state laws regarding private health information.
If you or your child are scheduled for their first appointment, please print and complete the following forms and bring them to your first visit. If you are scheduled for telehealth please email completed paperwork to [email protected]

• Face Sheet Form - Face sheet
• History & Physical Forms - Page-1 and Page-2
• HIPAA forms - Document-1 (This form is for your records.) and Document-2
• Authorization form to release information to their Primary Care Physician - PCP Release Form
• Financial Responsibility Form
*Optional
• Release of Information Form

Adobe Acrobat Reader is required to view and print the above forms. If you do not have this program click on the image below to download the latest free version.