History Intake Form for Coastal Psychological Center

Dear Families,

Welcome to our practice! We are committed to providing exceptional care to your child. Coastal Psychological Center is a clinical psychology practice founded by Drs. Kelley Knoch and Julia Morgan. We specialize in neuropsychological, psychological, and educational/academic assessments for individuals 18 months – 18 years old. Our evaluations are comprehensive and flexible. Through skillful assessment practices, child/adolescent interview, and collaboration with parents, clinicians, and educators we aim to uncover patterns of strengths and weaknesses to contribute to a deeper understanding of a child’s behavior, development, and skill set. Our reports are comprehensive and provide individualized recommendations for ‘next steps’ in assisting your child.

Practice Details: 

 Insurance and Payment Options:

·    Paying with Insurance: At this time, we only accept Blue Cross Blue Shield.   

  • Insurance coverage is dependent on referral question meeting medical necessity as defined by the insurance company.  Most commercial insurance plans do not cover routine neuropsychological assessments for ADHD, anxiety, or depression.
  • Any academic testing you request will be an out-of-pocket expense as it is not covered by insurance companies.
  • Waitlist: the waitlist associated with this payment method varies widely and is usually several months.  Please talk to your clinician regarding the most up to date information.

·    Private Pay Evaluations: Private pay options are available for individuals looking for expedited evaluations or for those with other insurance plans.  If we are not an in-network provider for your plan, you can try to be reimbursed from your insurance company by accessing your out of network services.  Private pay evaluations have many benefits.  There is no waitlist for private pay evaluations and we can typically schedule the initial parent meeting within a few weeks allowing you to quickly access your child's comprehensive treatment plan and recommendations.

oOut of Network Reimbursement:  Some insurance companies may reimburse for services rendered by out of network providers.  If you are seeking retrospective payment from your insurance carrier we will provide you with a detailed receipt or complete necessary forms that you obtain from your provider.  You are responsible for contacting your insurance company to determine eligibility as plans vary widely.

What happens during a comprehensive neuropsychological evaluation?

·      The first step is completing the below intake questions. If you prefer a paper packet, you can email us a request at intakes@coastalpsychologicalcenter.com. Once completed, your child is placed on our waitlist or if paying privately a clinician will reach out to you to schedule.

·      We assign a clinician based on availability and expertise. When an appointment is available the clinician will reach out to schedule an initial parent meeting. This is a 50-minute visit completed virtually to clarify referral question, gather relevant information, and answer your questions. At this meeting we will schedule testing session(s). 

·      Testing sessions vary based on the age and need of the child, but typically they are completed within 1-2 meetings with your clinician and last several hours at a time.  As a part of your child's assessment we review  outside documents or other evaluations they may have received, as well as collect information from other individuals who may know your child well, such as their teacher or therapist.  You, too, will complete questionnaires regarding your child's strengths, behaviors, and emotions.

·      Once the testing is complete a parent feedback meeting will be scheduled to review the results, impressions, and recommendations. This will be a virtual meeting as well. We also offer child and adolescent feedback sessions to help your child understand how their brain works and answer questions about the assessment process.

·      Shortly after you will receive a comprehensive assessment report that contains the important treatment recommendations and ways you can best support your child.

Please contact us with any additional questions.  We can be reached by phone at 978-276-9622 or email intakes@coastalpsychologicalcenter.com.

We look forward to working with your family!

Sincerely,

Julia Morgan, PsyD

Kelley Knoch, PhD


When you are ready, click the button below to being completing the intake paperwork.  Once the page opens in your web browser, click, 'next.'  The forms take approximately 10-15 minutes to complete.  If paying with insurance, have the information available before beginning the process.  Don't forget to email us copies of your child's early intervention reports, school based testing, 504b/IEP, and previous neuropsychological evaluations (intakes@coastalpsychologicalcenter.com).


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