New Patients

New Patients

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Appointments

Make an appointment today by phone. We are open from 9am to 5pm, Monday through Friday.
Please arrive 15 minutes early and bring your insurance cards as well as a form of ID.

Insurance Information

We accept and bill most insurance plans. Please contact your insurance plan for questions regarding mental health coverage with Fairborn Mental Health and applicable copays. You are welcome to contact our office at 937-318-8103 to inquire.

Payment

Payment of any deductible or copay is expected at the time of service.
We accept Medicare and most Medicaid insurers in the state of Ohio (Caresource, Molina, Paramount, and Buckeye).
We accept some private insurances. Please contact our office at 937-318-8103 to confirm if we are in network for you.
We also accept Private Pay patients for Mental Health.

New Patient Forms

Please take the time to complete and submit our online intake forms prior to your initial appointment. Our online forms are secure, HIPAA compliant, and can be completed from any computer or mobile device.

New Patient Registration Form

Personal Health History

Mental Health Questionnaire

Authorization to Disclose Protected Health Information

Drivers License/State ID and Insurance Card Upload

Request Information