Language
  • English (US)
  • Couples Center of the Pioneer Valley

    Please answer the following questions so we can provide you with a list of available appointments based on your insurance, availability, and preferences. You will receive an email with information on what to expect from our center upon the form submission. We will follow up with a response within 1-2 business days.
  • Basic Information

    If you decide to move forward with therapy, we'll need the following information to create an account for you inside our therapy portal so that we can send you the required paperwork: full legal name, date of birth, and email address.
  •  - -
    Pick a Date
  •  - -
    Pick a Date
  •  - -
    Pick a Date
  •  - -
    Pick a Date
  • Insurance

    If using insurance, we ask you to provide your insurance information on this form so that we can run your benefits and notify you how much your insurance is going to cover and if there is any deductible that needs to be met.

  • We ONLY accept and can bill in network for:
    *all Blue Cross/Blue Shield plans and
    *all United Healthcare products including UBH, Harvard Pilgrim, and Optum.

    We can usually bill one person’s health insurance ( “identified patient “) for a family therapy session.
    The remainder of the cost of the session will need to be paid out of pocket.

    If you are using one of these accepted in-network insurances we ask that you provide insurance information on this form so that we can run your benefits and let you know what they will cover and any deductible or copay you are responsible for.

    If you have out of network benefits, you will need to pay out of pocket; the identified patient may absolutely request a superbill from your clinician to seek reimbursement from your insurance company and we will be happy to provide that.

     


    Darrel Jones
    Senior Intake Coordinator
    Northampton, MA 01060
    COVID-19 Update: Our building is closed and we are now operating virtually.
    www.pioneervalleycouplestherapy.com
    (413) 570-0067

  • Specialized Services

    If using insurance, the wait time for an appointment may be 6-8 weeks. In cases where the conflict is urgent or time-sensitive, we offer a limited number of openings for people looking to begin couples therapy sooner. Please note that our specialized services below are not covered by insurance.
  • Image
  • Should be Empty: