New Patient Intake Forms

We empathize with your primary worry and have crafted a personalized client application specifically tailored to your needs. Simply reach out to our office and we will furnish you with a user-friendly link to effortlessly complete the application from the convenience of your own home.

Call our office to reserve your appointment. (586) 488-4818

NOTE: The brain mapping fee is paid at the time of appointment reservation.

Our staff will email the appropriate intake forms to you.

To ensure compliance with HIPAA regulations, we have established a secure portal where you can confidently send us your Protected Health Information (PHI). Our patient application process is designed to conveniently accommodate HIPAA-compliant uploads of all your materials.

Brain Mapping (qEEG) Hours

To secure the highest quality test results, brain mapping (qEEG) is only performed in the morning. Our testing schedule is as follows:

Monday, Wednesday, and Thursday from 9:00 am – 11:30 am

Insurance and Patient Financing Options

Neurofeedback is a groundbreaking technique that empowers the brain to unlock its full potential, enhancing self-regulation and paving the way for optimal healing and function. Our unique approach goes beyond targeting specific conditions, as we focus on assisting the nervous system in making subtle adjustments to improve overall well-being. By harnessing the remarkable power of neurofeedback, individuals gain the ability to regulate their brain activity, leading to a remarkable boost in cognitive performance and improved mental wellness. As we prioritize delivering personalized and innovative care to enhance wellness, care in our office is considered ELECTIVE and our services do not qualify for insurance reimbursement.

We offer a single payment discount or low monthly payments through Care Credit. You may qualify for interest-free options based on your credit score. No application fees.

No Surprises Billing Act

You have the right to receive a “Good Faith Estimate” explaining how much your health care program will cost

Under the law, healthcare providers need to give patients who don’t have insurance or who are not using insurance an estimate of the bill for medical items and services.

  • You have the right to receive a Good Faith Estimate for the total expected cost of any non-emergency items or services. This includes related costs like medical tests, prescription drugs, equipment, and hospital fees.
  • Make sure your healthcare provider gives you a Good Faith Estimate in writing at least 1 business day before your medical service or item. You can also ask your health care provider, and any other provider you choose, for a Good Faith Estimate before you schedule an item or service.
  • If you receive a bill that is at least $400 more than your Good Faith Estimate, you can dispute the bill.
  • Make sure to save a copy or picture of your Good Faith Estimate.

For questions or more information about your right to a Good Faith Estimate, visit www.cms.gov/nosurprises.