PCA Inquiry Match Questionnaire
Thank you in advance for your genuine and thoughtful responses.
Our heartfelt intention is to determine whether we can be of help and have the right clinical match for your unique needs, and to make useful recommendations for your care.
Once we’ve received your information, one of our Directors, who are all Clinical Psychologists, will carefully review what you’ve written and we will contact you today to discuss your needs in more detail.
If we receive your information after 3:30pm or over a weekend or holiday, we may not be able to get back to you until the next regular business day.
Five things to know before you begin:
- This form can only be completed in one sitting. You cannot save and return to it at a later time. So, please have all your information accessible, including your PCP and insurance information.
- We will only consider scheduling you with Doctors or Therapists who we judge to be good matches for your needs.
- Our Doctors and Therapists are highly sought after and so their time can be limited. Your availability will be an important factor when it comes time to reviewing available appointments with Doctors or Therapists who are the right match for you.
- Because we know that looking for the right care can be a time-consuming and stressful process, if we determine that we don’t have what you need (taking into account the clinical, insurance and logistical information your provided), we will inform you promptly by email so as not to delay your search.
- We accept all insurance except Fallon, Tricare, and Mass Health (includes: BMC HealthNet, NHP, Minuteman).