Service Order Form
  • Service Order Form

    Please make sure to fill in the required fields and submit this form to complete your order.
  • SHYAS SERVICES

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    Intake and Assessment. Comprehensive Clinical Interview with Therapist 1.5 - 2 hours
    Intake and Assessment

    Comprehensive Clinical Interview with Therapist            1.5 - 2 hours

    $150.00$150.00
      
    Psychiatric Evaluation. Comprehensive Clinical Interview with psychiatrist that may include prescription 1.5 - 2 hours
    Psychiatric Evaluation

    Comprehensive Clinical Interview with psychiatrist that may include prescription 1.5 - 2 hours

    $200.00$200.00
      
    Medication Evaluation - 30 Minutes. Medication Evaluation is the reconciliation and review of meds to ensure no unsafe interactions or drug practices.
    Medication Evaluation - 30 Minutes

    Medication Evaluation is the  reconciliation and review of meds to ensure no unsafe interactions or drug practices.  

    $150.00$150.00
      
    Medication Management- 25 Minutes . Medication Management is the prescription, administration, and review of medications.
    Medication Management- 25 Minutes

    Medication Management is the prescription, administration, and review of medications.

    $110.00$110.00
      
    Medication Management - 15 Minutes. Medication Management is the prescription, administration, and review of medications
    Medication Management - 15 Minutes

    Medication Management is the prescription, administration, and review of medications

    $90.00$90.00
      
    Outpatient Therapy - 1 Hour. SHYAS provides individual & family therapy to help you mange the challenges of life and address mental health and substance use symptoms.
    Outpatient Therapy - 1 Hour

    SHYAS provides individual & family therapy to help you mange the challenges of life and address mental health and substance use  symptoms.

    $120.00$120.00
      
    Outpatient Therapy - 30 Minutes . SHYAS provides individual & family therapy to help you mange the challenges of life and address mental health and substance use symptoms.
    Outpatient Therapy - 30 Minutes

    SHYAS provides individual & family therapy to help you mange the challenges of life and address mental health and substance use  symptoms.

    $75.00$75.00
      
    Outpatient Therapy Group . Group therapy is used to address a specific mental health and/or substance use concern with peer support. It is the most effective form of treatment.
    Outpatient Therapy Group

    Group therapy is used to address a specific mental health  and/or  substance use concern with  peer support. It is the most effective form of treatment.

    $60.00$60.00
      
    In Home Therapy - 1 Hour. Therapy provided to youth and/or adults in their home or private community-based setting is In-Home therapy.
    In Home Therapy - 1 Hour

    Therapy provided to youth and/or adults in their home or private community-based setting is In-Home therapy.

    $150.00$150.00
      
    DWI - Intake and Assessment. Each DWI infraction requires an assessment. A DWI assessment is only good for 6 months. Please note you must follow through with the treatment recommendations within 6 months or you must pay for another assessment.
    DWI - Intake and Assessment

    Each DWI infraction requires an assessment. A DWI assessment is only good for 6 months. Please note you must follow through with the treatment recommendations within 6 months or you must pay for another assessment.

    $100.00$100.00
      
    DWI - DMV Record. Must accompany assessment to determine the number of assessments you must pay for. Each DWI or DWLR infraction with an * beside it is equivalent to 1 assessment/$100.00. Please Note: we do not count the infraction with an * if it is duplicated on the record.
    DWI - DMV Record

    Must accompany assessment to determine the number of assessments you must pay for. Each DWI or DWLR infraction with an * beside it is equivalent to 1 assessment/$100.00. Please Note: we do not count the infraction with an * if it is duplicated on the record.

    $15.00$15.00
      
    DWI - 20 hour Short Term . 2 hours per class 2 days per week for 5 weeks Can not complete prior to 30 days
    DWI - 20 hour Short Term

    2 hours per class 2 days per week for 5 weeks Can not complete prior to 30 days

    $350.00$350.00
      
    DWI - 40 Longer Term. can not complete prior to 60 days 2hrs per class 2 days per week for 2 months
    DWI - 40 Longer Term

    can not complete prior to 60 days 2hrs per class 2 days per week for 2 months

    $600.00$600.00
      
    DWI - IOP  . Substance Abuse Intensive Outpatient Program 3hours 3 days a week for 3 months
    DWI - IOP

    Substance Abuse Intensive Outpatient Program 3hours 3 days a week for 3 months

    $2,000.00$2,000.00
      
    DWI Treatment Review. If you do not complete pay to complete services with SHYAS DWI Program. You completed treatment with a different program and you provide proof of successful completion and negative urine drug screens.
    DWI Treatment Review

    If you do not complete pay to complete services with SHYAS DWI Program. You completed treatment with a different program and you provide proof of successful completion and negative urine drug screens.

    $75.00$75.00
      
    SACOT. Substance Abuse Comprehensive Outpatient Treatment 4hours a day 5 days a week for 4 months substance use partial hospitalization 120 day treatment
    SACOT

    Substance Abuse Comprehensive Outpatient Treatment  4hours a day 5 days a week for 4 months substance use partial hospitalization 120 day treatment

    $4,000.00$4,000.00
      
    ADETS. ADETS - Alcohol & Drug Traffic School 16 hour substance use prevention and education Prime for Life Curriculum. Must purchase the book.
    ADETS

    ADETS - Alcohol & Drug Traffic School 16 hour substance use prevention and education Prime for Life Curriculum. Must purchase the book.

    $160.00$160.00
      
    ADETS Work Book. Prime For Life Work Book must add $5.00 for shipping and handling pick up from the office is available
    ADETS Work Book

    Prime For Life Work Book must add $5.00 for shipping and handling pick up from the office is available

    $25.00$25.00
      
    Total
    $0.00$0.00
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