Appointment forms and information

If you have any questions, contact us at 260-969-5583 or email at cbt@iccbt.org

Before your first appointment, you will need to complete the online intake information form. Our staff will guide you through the process of accessing and completing the information online.  We use an electronic medical record system that includes encrypted (private) messaging directly between you and our clinical team, so make sure you complete the process of becoming enrolled in the system. 

Please bring the following to your first appointment:

1. Your name, current address, phone number, email address. Also bring names, addresses, phone and fax numbers of all current health care providers (like your family doctor or specialists), psychotherapists, and any past psychiatric treatment providers
2. A complete list of all of your current and recent medications, (including over-the-counter medication and herbal preparations) and/or bring in your current prescription bottles.
3. Copy of any Medical Records in your possession
4. Patients under the age of 18 should bring their most recent school behavior report, grade card and/or a symptom checklist completed by teachers. (we can send you a checklist by email - just ask ahead of your appointment).
5. If you would like to use your medical insurance, please bring a copy of your insurance card and any other information required for submitting your claims.

*****Most, but not all, clinicians at CBT accept Medicare and most major insurance plans. We will help you to confirm your coverage prior to making an appointment. Please contact our business office to discuss your individual insurance and payment needs. We currently do not accept Medicaid.