Blueprints
Start Therapy/Forms
Please Complete The Following Steps To Successfully Initiate Services:
- Contact your insurance company to verify with your insurance company if there would be coverage for the services your child needs. Questions to ask include:
- If there is coverage, are there any exclusions?
- Do I have a neuro-developmental benefit?
- Do I have a co-payment or is there a percentage of the bill I will be responsible for?
- Does my plan require a deductible be paid for the calendar year before the coverage begins?
- Does my insurance plan cover only a limited number of sessions for each calendar year?
- Is there a requirement that I get a prior authorization and/or a referral/order from my physician before I see a clinician?
- Obtain order/referral from your child's physician if you haven't already.
- For more info about Psychological / Mental Health Services, schedule a phone meeting with a member of our team.
- For more info about Behavioral Health Services, schedule a phone meeting with a member of our team.
- For more info about our Skill Builders Preschool Program, email skillbuilderspreschool@mosaicrehab.com.
- To start the intake process for Psychological / Mental Health Services, complete the appropriate forms below and email, fax or mail the forms back to MOSAIC Children's Therapy.
- Email: Jennifer Bonow jbonow@wcblueprints.com
- Fax: (425) 732-4606
- Mail: 13010 NE 20th St, Suite 300, Bellevue, WA, 98005
Note: Your intake forms and any other requested information must be received no later than one week before your scheduled appointment.
Available Forms:
