Prior to the intake appointment, please complete the following paperwork. Forms can be completed online and are submitted by a secure, HIPAA-compliant system to protect information.
Paperwork is required and must be completed and submitted by 8:00a the day before the appointment. This allows me time to verify insurance/payment information and review patient information to use our time during the intake as efficiently as possible. Intake appointments may be canceled/rescheduled if paperwork is not completed and submitted as requested.
If you have any difficulty accessing the links, or if you are unsure of which set of paperwork to complete, email Dr. Larsson at a.larsson.phd@gmail.com. Forms can be completed multiple times following the same link. For example, several ROI Forms could be completed if the patient has multiple providers (medical, therapy, etc.) and an Intake Form could be completed twice by two parents/guardians in different homes.
Please review the Patient Portal for information about received/missing forms.
Pediatric Patients (age 17 and under)
Using Insurance: Premera, Regence, BCBS, HMA
Without Insurance, OON, Private-Pay
Adult Patients (age 18 and older)
Using Insurance: Premera, Regence, BCBS, HMA
Using Insurance: Premera, Regence, BCBS, HMA