Psychiatric Services - Medication Management

Blue Tide Therapy is pleased to announce that we will soon be offering psychiatric services for both new and existing clients in Florida via telehealth. These services will initially be available on a cash pay basis, with the option to submit claims to insurance. Please note that payment is due at the time of service, and no payment from insurance is guaranteed. We look forward to supporting our clients in their mental health journey!

Name

First Name

Last Name

Date of Birth

Interested in services for:

Self

Child(ren)

Child #1 - Name

First Name

Last Name

Child #1 - Date of Birth

Child #2 - Name

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Child #2 - Date of Birth

Child #3 - Name

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Child #3 - Date of Birth

Child #4 - Name

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Child #4 Date of Birth

Child #5 - Name

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Child #5 - Date of Birth

Additional Information - Comments