New Client Instructions

Those interested in becoming a new client can follow the steps and read over the information below to expedite the process.  

GSCC NJ / Ascending Wellness & Psychotherapy LLC, thanks you for reaching out!

 We are grateful you are seeking services with us and look forward to providing you with only top quality telehealth counseling.  We need some basic information to see which one of our providers are the best fit for you.  Some of our therapists are currently in network with most Cigna, BCBS, and United Healthcare plans but not Medicaid/Medicare/Community.  

Once we receive this information, someone will be in touch with you as soon as possible to give you information on moving forward with scheduling your first appointment. Please note that we cannot move ahead without the following information.  

1) Which insurance do you currently hold if any?

2) If we are not in network with your insurance, are you interested in paying out of pocket for sessions on either a sliding scale or out-of-network basis?

3) Your general availability for sessions (days/times)?

4) Do you have a preference of the gender of your therapist ?

5) Are you requesting a particular therapist?

**Please note that Samantha Smith LCSW and program director is not taking new clients at this time.**

6) Are you aware that our services are not rendered in person, but rather you will see a counselor/therapist by phone or video chat?

For anyone who wishes to expedite your intake process, clients who would like to use Cigna, UnitedHealthCare or Blue Cross of NJ (no community Medicaid versions of these plans accepted at this time), or those who are planning to pay out of pocket may begin by completing the information below and emailing it back.

Full name (client 1):

Preferred name (if different than above:)

Pronouns: 

DOB: 

phone number: 

email address: 

Home address: 

County of residence:

Place of employment: 

A brief description of why you are seeking services: 

Photo of the front and back of your insurance card: 

(please copy this section again if you are seeking services for couples counseling and enter the partners information)

(The following to be completed if you are not the primary insured person on your plan) 

Primary insured individuals full name: 

Primary insureds DOB: 

Primary insureds address: 

Primary insureds place of employment: 

Please note:

We may take up to 72 hours to get back to new client requests.  If this is an emergency, please call 911 or go to your local emergency room.  We are not an emergency service.  

Clients are responsible for confirming that we are in-network with your plan. If we are not in network with your plan, you may accrue a balance which will be your responsibility as per insurance guidelines. Please contact your insurance with the following information to check if we are in-network.

**THIS PRACTICE HAS A 48 HOUR CANCELLATION POLICY AND A $200 CANCELLATION FEE**

 

GSCC of NJ
NPI: 1356852776
Tax ID: 82-4938869