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Intake Forms ​

Printable

Please arrive 20 minutes early for first appointment to fill-out paper work and bring proof of income and payment. OPTIONAL-- You can download initial paperwork, print and fill-out at home and bring to first appointment

New Day Counseling is paneled with many health insurance companies and for self-pay we have a sliding scale

PHONE

248-649-8050



ADDRESS

306 Town Center Drive

Troy, MI 48084

Blue Cross Blue Shield, Blue Care Network, Aetna, Priority Health, ASR, McClaren Advantage & Commercial, Optum, United Health Care Commercial, United Behavioral Health, Carelon/Beacon, UMR Beaumont, Magellan and FSA/HSA.


We may be able to use out of network benefits, please contact us. We also are paneled with a number of EAPs.


We DO NOT take any insurances not listed above including Mediciad.


If you do NOT have insurance, we offer a sliding scale fee based on yearly family income.  Review the sliding scale fee to determine cost.


Forms of payment accepted – cash and credit cards (NO Checks)

Sliding Scale Fees Based on Yearly Family Income


If you do NOT have insurance, we offer a sliding scale. We make counseling affordable for everyone.


**Must provide proof of income -- a copy of last year’s Federal Income Tax Form 1040 or other proof of income to qualify for a reduced rate. 


Each session is 50 minutes.

Yearly Income -Each Session /Assessment Session (1st appt only)   


$160,000-$169,000+                       $195/ $225


$150,000-$159,000                          $185/ $215


$130,000-$149,000                          $175/ $205


$120,000-$129,000                          $165/ $195


$110,000-$119,000                            $155/ $185


$100,000-$109,000                          $145/ $165


$80,000-$99,000                             $125/ $155


$60,000-$79,000                             $115/ $145


$40,000-$59,000                             $105/ $135


$39,000 and under                          $95/ $125

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