Existing clients, please use the portal to schedule appointments.
WELCOME! You found the Appointment Request Page
We are so HAPPY you made it this far!
•We know it was hard getting this far. You are only 15-20 minutes of your time, from scheduling your first session.
Don’t give up now.
Quick Fact: Over 75% of people who intend to see a therapist, fill out the request and then don’t do the onboarding to get on the schedule?
That’s the old you, not the NEW you, don’t let that be you any longer.
•If you are ready to DO THINGS DIFFERENT, don’t delay. It’s normal to meet with more than one therapist before finding the right fit.
Ready to Take the Next Step?
Read on for a few important clinic policies
Insurance & Payment
-We do not bill out-of-network or secondary plans.
-We can not bill Medicare plans (we are not in-network and can’t get a denial to send to your secondary). If you have a commercial plan that is primary to your Medicare or if you have BCBS combined with your primary Medicare than we likely can bill for payment. Please call your plan if you are not sure.
-If your plan isn’t listed or you would prefer full confidentiality of your sessions, you can pay at the clinician self-pay rate and submit for reimbursement. Some plans cover out-of-network services similarly to in-network.
-Completing forms may feel tedious, but it’s required by insurance.
What Happens After You Submit the Form?
Once you submit the appointment request, our administrator, Kirstin, will contact you within 24 hours (Monday–Thursday) to confirm your request.
If you requested a provider and they aren’t accepting new clients or don’t have immediate openings, then Kirstin will:
-Suggest another provider with the same specialty, or
-Put you on a waitlist for your preferred provider if possible.
•If you have not done so yet, please visit our common questions page so you know what to expect at this clinic.
We are committed to your privacy. Please do not include confidential or private information regarding your health condition in this form or any other form found on this website. This appointment request form is for general demographic information to get you set up in the portal for onboarding.
By clicking ‘Submit’ you agree that the phone number you provided may be used to contact you.
Frequently Asked Questions
How long does onboarding take?
We know time is important. This takes 15–20 minutes and is required by all clinics for insurance purposes.
Is this form HIPAA compliant?
This request form is secure but not HIPAA-compliant. Sensitive details about your health is collected inside our Electronic Health Record portal.
Which insurance plans do you accept?
We accept Aetna, Blue Cross Blue Shield, Cigna, Health Partners, Medica, UMR, OPTUM, UHG, First Health, UCare. See our full Rates & Insurance page for details.
Can I request a specific therapist?
Yes. You may indicate a preference or let us recommend the best fit for your needs.
What happens after I submit the form?
Our administrator will reach out within 24 hours (Monday through Thursday 8am-4pm) to confirm your appointment and guide you through next steps. If for some reason you don’t feel we received your request, you can fill it out again or contract our administrator Kirstin at admin@breckecounseling.com
More Resources
Meet Our Providers (all fully licensed at the Master’s or Doctorate level)