Primary Insured Member Information:
I authorize the release of any information necessary to process claims with my insurance company and I authorize my insurance company to make payments for my treatment directly Serenity Behavioral Health Services. I understand that I am responsible for paying my deductible or co-pay (where applicable). I agree to pay the cost of each session.
I authorize Serenity-BHS to check benefits on behalf of the client seeking counseling.
This website is HIPPI Compliant and all information submitted is ENCRYTED and SECURE.
Please complete the following information in order for our billing department to check your Health Insurance Benefits prior to your first appointment.
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