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New Clients – Cmecfl

New Clients

If you are using your insurance plan, please complete the following form and return it to our office by e-mail or fax at least 24 hours prior to your appointment.
info@cmecfl.com

Adult Intake Form
Child Adolescent Intake Form
insurance Screening Form

Please complete the following Consent / Personal History, Client Rights, and Responsibilities forms and bring the completed forms to your first appointment:

Adult Personal History Form
Child/Adolescent Personal History Form
Client Rights, and Responsibilities

If you would like us to have the ability to communicate with or send records to another party, we need a request in writing as well as written consent to release specific information. Please complete the following form and return it to our office by e-mail or fax with your written request for information:

Authorization to Release Information Form

drposley@cmecfl.com 

Referring Agencies

We gladly accept referrals from other agencies. Please fax the attached form back to us at (407) 732-6623 and we will contact the client to schedule an appointment.

Referral Form

Please send a release of information with the referral in order for us to notify you of the contact made. You may send your own release form or use our release form.

We accept the following forms of payment

We accept Medicaid and other Insurance Plans including Sunshine, Ambetter, Wellcare, Staywell, Amerigroup, Optum, United Healthcare, Magellan, Psychcare, Value Options, Beacon, and Molina.

We are continuously adding other insurance plans to our agency. If your insurance plan is not listed above please call our office and inquire about us joining your plan.