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Individual Appointment Questionnaire 

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    i.e. are you seeing a counselor regularly?
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    Please call 724-396-1510 or contact your counselor directly.

    Since you're an active client at CCA, our intake department or your counselor will be able to help you best over the phone.

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    You can select multiple options
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    Please provide the best way to contact you, or identified client.
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    Please enter contact details for the person completing this form.
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    • Parent/Guardian
    • Spouse
    • Friend
    • Other
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    You can add a message here for our intake department if you would like to ask questions or provide additional details.
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    Book your appointment now with our easy online scheduler - your first session is just a click away! Or, you can choose to have our intake department contact you.
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    Please enter the name of your insurance plan or plans (UPMC, Highmark, etc.) and indicate if this Plan is Medicaid, Medicare, or a Medicare supplement. We cannot guarantee that your plan will be accepted or will be able to be used for sessions/evaluations.
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    We can help you find an appointment or add you to a waitlist.
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    Online Scheduling Guidelines

    • Having Trouble Scheduling? - If you are having trouble finding an appointment, please call 724-396-1510 or email us at appointment@ccawpa.com. There may be more appointments available when you call. Our intake staff can schedule an appointment for you with no booking fee required. They are standing by Monday-Friday from 8:30am-5:30pm.
    • Booking Fee - Using our online scheduling system requires a booking fee of $60 to hold your appointment. Our intake department will verify your information and if you make an appointment with someone by mistake, our Intake staff will refund your booking fee to you. If you attend the appointment the booking fee will then be applied/credited to the balance for the first session whether it be your copay or cash rate.
      • Please be aware - The booking fee is not the cost of the session. The cost of the session varies by counselor rates as well as Insurance copays/deductibles vary by insurance plans. Your booking fee will go towards the cost of the first session(s).
    • No Show or Late Cancellation of Booked Appointment - After making an appointment through our booking system, if you no show or late cancel the appointment, CCA will keep the booking fee as a non-refundable late fee. If you want to cancel a booked appointment you must contact the intake department 48 hours prior to the appointment time in order for your booking fee to be refunded.
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    Our Apologies

    Unfortunately, CCA is unable to provide counseling services to those residing outside the states of Arkansas Pennsylvania, Ohio, New York, and West Virginia. We are praying that you find the counseling services you need closer to home!


    You can contact our intake department at 724-396-1510 with any questions.

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