Make an Appointment
To help you understand the new client intake process
please CLICK HERE
before completing the New Client Inquiry Form Below!
Some of the plans that we CANNOT ACCEPT include:
* ANY form of Medicare or Medicaid (e.g., Wellcare, Staywell, Molina, Sunshine, CMS, etc.)
If you have one of these plans and receive services, you are considered a ‘self pay’ client and will be required to pay out of pocket for the entire cost.
Please complete the form below in its entirety! Dependent upon the day of your submission in relation to the timing of the next administrative meeting, please expect a reply from the intake coordinator within 2 to 5 business days. For your convenience, the intake coordinator will respond VIA EMAIL, unless you specifically decline consent for email correspondence; the intake coordinator will also follow up VIA PHONE to ensure the email was received, so please also be sure to check your voicemail regularly.
If you do not hear from the intake coordinator within 2 - 5 days, or if you have any questions,
PLEASE EMAIL INFO@BEACONPEDIATRIC.COM TO FOLLOW UP FOR THE QUICKEST RESPONSE!
~ The main phone line is * NOT * a live monitored line and may not be answered immediately. ~
Please keep in mind that communications via email and over the internet are not secure. Although it is unlikely, there is a possibility that information you include in an email or online form can be intercepted and read by other parties besides the person to whom it is addressed. By completing this form, you are confirming that you understand this and consent to communication with Beacon Pediatric Behavioral Health via email and over the internet.