To reduce the risk of missing a form, please begin with “1. Intake Form” and fill out each form in sequence, online. Once a form has been completed and submitted you will automatically be prompted to complete the next form on the list.
Please Note: we are currently experiencing a high demand for our services. Please be patient with us until we are able to get back to you. We will contact you within 2-4 days from the date you submit these online forms to begin the scheduling process.
Here are some helpful hints to make this process go smoothly:
1. Provide information for all of your health insurance(s) - front and back of the card. We need both your primary health insurance and your secondary health insurance cards, if you have them. Please provide the name, date of birth, address, and the relationship to you of the person who is the primary subscriber on the health insurance plan.
2. Before completing our online forms, contact your health insurance company and ask them about your benefits. What is your copay? Does your medical deductible need to be met before your insurance will help pay for services? Depending on your coverage, having to meet a deductible first can mean a difference of a $25-30.00/copay or $85.15-125.00/copay cost.
3. We are no longer accepting the following insurances: Molina, Beacon Health Options, or Medicare.
4. We are currently not accepting secondary insurances.
5. We are currently not accepting Aetna EAP or Anthem EAP clients. We have very limited availability for placing EAP clients. The more flexibility you have in your schedule helps. Using health insurance instead of an EAP plan can help, as we have a limited number of EAP providers. Please ensure that we receive EAP authorization prior to completing our Intake paperwork.
6. The majority of our available sessions are between 9am and 3pm. Being flexible with your schedule can help with getting an appointment sooner. Most therapists' evening sessions are booked for several months, but cancellations can open up a time slot.
7. If you schedule an appointment and do not cancel more than 24hrs in advance, you will be charged a $50 Missed Appointment Fee. You will not be rescheduled for future sessions until that fee is paid. Please be considerate of our therapist's schedules and the need of other clients who are waiting for a time slot to open up with their therapist, by canceling any appointments with more than 24 hours notice.
Thank you for your patience and understanding.
In order to start working with a Serenity therapist and schedule a therapy session,the following forms listed below must be filled out and submitted. Please complete these forms in order, from 1 through 7. When we receive your submitted information, our Intake Coordinator will contact you to schedule your first appointment. We will e-mail you a Welcome Packet after your first appointment is scheduled. The Welcome Packet provides further information detailing the services we provide, policies specific to cancellation, communication, confidentiality; client's rights, and information about our compliance with HIPPA.
The Adult or Child Medical History and Consent for Treatment forms are required prior to your first appointment. These forms provide us with the necessary information to meet you and help create an assessment of your current mental health status. Please take your time in completing the forms and answer all questions to the best of your ability.
5011 Pine Creek Dr.
Westerville, Ohio 43081
Our office hours are Monday through Friday from 8am to 8pm, Saturday 9am to 3pm, and we are closed on Sunday.
495 E. Mound Street, Suite 110
Columbus, Ohio 43215
Phone: 614/ 948-3273
6465 Reflections Drive, Suite 110
Dublin, Ohio 43017
623-H Park Meadow Road
Westerville, Ohio 43081