LOOKING TO MAKE AN APPOINTMENT?
WE ARE HERE FOR YOU!
We are accepting new clients for both telehealth and in-person sessions. Please complete our confidential Appointment Request form to get started. Once submitted, it is reviewed by our Intake Coordinator and assigned to a therapist or intern who will contact you to schedule your first appointment. Learn more about us by clicking on About or review our staff bios by clicking on Staff.
CURRENT CLIENTS
Current clients complete additional forms below when requested by your therapist.
RATES / INSURANCE
The Peacemaker Center does not take insurance and is not in network with insurance companies. Upon request, our clinicians will provide a receipt with proper codes that can be submitted to your insurance company for out-of-network reimbursement of our fee. Our fee is based on a sliding scale with full pay set at $150 per 50-minute session. We can offer a reduced fee to those in need, based on our sliding scale.
PAPERWORK
Anger Assessment
All are welcome to complete the Anger Assessment.
Consent
All clients are requested to sign a Consent. Both parents/guardians sign for children under age 14.
Depression Screening
All are welcome to complete the Depression Screening.
Life History
Complete the Life History when requested by your therapist.
Appointment Request
To request an appointment complete our confidential Appointment Request.
Couples Accessible, Responsive, Engaged Questionnaire (A.R.E.)
Complete the A.R.E. Questionnaire when requested by your therapist.
Devereux Adult Resilience Survey (DARS)
Complete the DARS when requested by your therapist.
Recreational Activities Release
Complete the Recreational Activities Release when requested by your therapist.
Authorization for Release
Complete the Authorization for Release when requested by your therapist.
Couples Dyadic Adjustment Scale
Complete the Dyadic Adjustment Scale when requested by your therapist.
Feelings List
All are welcome to complete the Feelings List.
Scholarship Application