Family Life Consultants


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FORMS



Registration Packet



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Release of Information Form



Credit Card
on File
Form



Insurance information





We accept most insurance* and work with many EAPs. If you would like to know if your insurance is accepted then you can give that information to us on the request for first appointment form. If your insurance is not accepted then we can also provide private pay options, starting as low as $65.


*We do not take Medicaid or any other State Funded Community Health Plans (Molina, Meridian, State medical Card). If you have one of these we can only offer Private Pay option.



Family Life Consultants
2014 Vandalia St.
Collinsville, IL 62234
Phone: 618-345-9536
Fax: 618-345-9587