New Patient Forms
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Click the links below to download the corresponding form.

Genesis Clinical Services accepts the following Insurance Plans:  Blue Cross PPO, Medicare, Aetna PPO.    All other carriers are considered out of Network.  We do offer competitive self pay rates for 1st initial evaluations and follow up appointments  with all our Providers.  A copy of the Encounter Form will be given to each patient at time of visit.  Patients can submit to out of network carrier for reimbursement.

                                                     Initial Evaluation                    Follow-up Appointments
MD, DNP, APN                                $295                                   $150       30 minute session (Medication Management)

PhD, PsyD                                         $250                                   $165       45-60 minute session 

LCPC, LCSW, LPC                           $225                                  $145       45-60 minute session