Appointment Request

Please correct the errors described below.

We currently have availability for Medical Assistance and self-pay/out-of-network clients. If you have another insurance (UPMC, Capital, Highmark, other BC/BS, or TriCare) please check back - our therapists who are credentialed with those insurers are currently full.

Please use this secure form to request an intake appointment. We will review the information you provide to determine whether we have a therapist available who would be a good fit. Our Client Care Coordinator, Christine, will be in touch within 1-2 business days. We look forward to speaking with you!

**Please note that completing this form does not guarantee an appointment.**

Contact Information

Client Information

We need to know the client's age, in order to assign an appropriate therapist. Date of birth also helps us to check insurance benefits.
We currently have availability for Medical Assistance and self-pay/out-of-network clients. If you have another insurance (UPMC, Capital, Highmark, other BC/BS, or TriCare) please check back - our therapists who are credentialed with those insurers are currently full.
Having your policy number enables us to check your mental health benefits, so that we can provide you with benefit information when we contact you.

Please note that this is a request for an intake appointment and does not guarantee an appointment. We will review the information you have provided to determine whether we have a therapist available who would be a good fit. Our Client Care Coordinator, Christine, will be in touch within 1-2 business days. If you have indicated it is okay to email, please keep an eye on your spam folder and/or add Christine@CampbellPsychPA.com to your address book.

Your message will be encrypted and can only be read by Campbell Psychological Services.