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    If you are in crisis and are unable to reach your therapist, call the Crisis line at (808) 832-3100, call 911, or proceed to your nearest emergency room immediately.  

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    Welcome to the Mililani Psychology Group


    Thank you for considering us!  We gather basic information here to better serve you - with a response usually within 4 business days via email. 

    Please only include information you are comfortable sharing.   

     

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    Please indicate the client's availability by checking the boxes below.
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    Mililani Psychology Group accepts HMSA, HMSA Quest, HMAA & UHA as your PRIMARY carrier. If you have any other insurance, the out-of-pocket cost is $150-$250 per hour (see Fee schedule).
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    Unfortunately, we are unable to provide documentation services related to job/work readiness, workmen's compensation, disability determination, or legal issues (i.e. to attorneys; custody) given our scope of practice. 

    If you are unsure, you may list your specific request/concern in the Comment section below so we can best assist you.

    Otherwise, you may exit this form at this time.

    Thank you for contacting us.

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    Please indicate if there is a specific provider requested.
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    Current or more recently completed grade.
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    If parents are not together (there is a separation, divorce or custody agreement), we require consent from BOTH of the minor's parents or legal guardians PRIOR to scheduling an intake appointment. Each parent or legal guardian MUST complete and sign the electronic Policies & Consents. Upon receipt of this completed form, we will send electronic Policies & Consents to each parent using a secure link or Client Portal using the email addresses provided.

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    In the event that only one parent has SOLE LEGAL custody, we may require supporting court documentation.

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