• Forms and Insurance

  • Insurance

    We are currently in-network with UHC, BCBS and Aetna for medical disorders.

    Please complete the form below and send to our bookkeeper, Joann Bell at fax: 817-516-8291 or email: [email protected] Once your insurance is verified, and your out of pocket expenses determined, we can make an appointment for your evaluation. For further questions you may call Joann at 817-516-7019.

    If you are paying out of pocket, the cost of the evaluation is payable in two payments – at the time of testing and then at the time of feedback.

    • Insurance Form (PDF)

    Forms

    • Welcome to CNCC (PDF)
    • Private Pay Consent for Testing (PDF)
    • Consent for Testing - Insurance (PDF)
    • Financial Policies (PDF)
    • Medical History (PDF)
    • Protected Health Information Consent (PDF)
    • Release Form (PDF)
    • Notice of Privacy Practices (PDF)