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    Submitting this form DOES NOT GUARANTEE or SCHEDULE AN APPOINTMENT! Our staff will review the information and will contact you via email if we are able to schedule.

     

    IMPORTANT (RE: LOCATION): PLEASE READ!!!


    Some appointments may be offered in-person depending on the provider and depending on necessity, but please expect the first appointment to be via Zoom for all services. Appointments with Dr. Cindy Anderson are virtual only, no exceptions.

     

    EVALUATION/ASSESSMENT

    Current wait time for an evaluation/assessment is about two (2) to three (3) months. We are only able to evaluate folks age seven (7) and up at this time.

    If you have a poor internet connection or computer that is not able to run Zoom properly (example: school Chromebooks), we may not be able to complete the assessment and you may be referred elsewhere.

    There will be MULTIPLE appointments. Typically between four (4) and five (5) total. Each appointment is typically scheduled for two (2) hours. We do not provide court-ordered evaluations/assessments.

     

    ADULT THERAPY

    You are welcome to complete this form to be added to a general waitlist. However, please note that our wait time can vary for this service. Our staff will reach out to you via email to let you know if we are able to schedule.

     

    CHILD THERAPY

    We NO LONGER OFFER CHILD/ADOLESCENT THERAPY SERVICES at Hope Springs. If you (or your child) are under the age of twenty (20), please do not complete this form as we will not be able to accommodate the request.

     

    If you have more questions, feel free to email us at contact@hopesprings.net.

    Proceed to the next page to complete the New Client Request form.

  • DOB*
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  • We are only able to evaluate folks over the age of seven (7) at this time. Please do not continue with this form.

  • We do not provide court-ordered services/assessments. We do not work with lawyers, court cases, etc. Please do not continue with this form.

  • Format: (000) 000-0000.
  • Will you be located in Iowa during the time of your appointments?*

  • You MUST be located in Iowa for all appointments, even if it is on Zoom. Please do not continue with this form.

  • HEY - you selected Dr. Cindy Anderson! She ONLY offers appointments virtually on Zoom!!! NO EXCEPTIONS. If you are NOT okay with this, please do not continue with this form. We do not have any other providers for children/adolescents. Thank you!

  • You selected "BlueCross BlueShield (Out-of-State)" or "BlueCross BlueShield (Anthem)". While we are in-network with these plans, they typically do not cover any service at our office or cover very little.

    You are responsible for checking your benefits prior to scheduling, and preauthorization may be required. If you have a high deductible or do not have coverage, Neuropsychological/psychological evaluation/assessment is roughly $4000 and therapy sessions are $175/session: we require a valid card kept on file to process any charges not paid by your insurance.

    If this does not work for you, please do not submit this form as there are no exceptions to this policy. Thank you for understanding.

  • You selected "Not Listed (Out-of-Network). This means we are not in-network with your insurance and you likely do not have benefits for any service at our office. If you would like to proceed, please know that it will be considered private pay.

    Neuropsychological Evaluation/Assessment is $4000: we require $2000 paid at the time of scheduling and $2000 paid at the first appointment. Therapy sessions are $175/session: we require $200 paid at the time of scheduling and will need a valid card kept on file to process the full charge at each appointment.

    If this does not work for you, please do not submit this form as there are no exceptions to this policy. Your primary care physician or insurance may have other suggestions that are in-network. Thank you for understanding.

  • Hope Springs Behavioral Consultants

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