Adult Intake Packet
If you are a new patient, please fill out all of the forms and bring them with you to your appointment along with your insurance card and drivers license.
Child Intake Form
If you are a new patient under the age of 18, please fill out these forms, as well as the "DSM Child Form" and bring them with you to your appointment along with your insurance card. Thank you.
DSM Child Form
The following is the list of insurances with which we participate. This list will be updated from time to time as needed:
Ambetter of Tennessee
Benefit Administrative Systems
Cigna Behavioral Health
Military One Source
TLC Benefit Solutions
United Health Care
*Insurance participation varies amongst EnSpire Counseling & Wellness providers, please be sure to verify participation with your insurance prior to your visit.*
- You should always check with your EnSpire Counseling & Wellness provider to verify plan and product coverage as this is not an exhaustive list, and plans change frequently.
ALL COPAYMENTS/DEDUCTIBLES ARE DUE AT THE TIME OF SERVICE.