There is no greater agony than bearing an untold story inside you.Maya Angelou

Intake Packet

Prior to your first appointment download, print and fill out the Boulevard Therapy’s Intake Packet. You will be provided the password for this page when your appointment is made.

Intake Packet

Insurance Verification

Before your first visit, please check your insurance coverage and benefits for behavioral health services.

On the back of your card you will find a phone number for members (or use the online tool). There may be a separate phone number for behavioral/mental health benefits. Questions to ask for individual and couple (family w/patient present) sessions:

  1. Do my benefits cover outpatient behavioral health services (90837 or 90834 or 90847) in an office setting?
  2. Are behavioral health benefits carved out to another company (Third party) and if so, which company and their billing address?
  3. Do I have a deductible? If so, how much? And, how much has been met?
  4. Do I have a co-pay or co-insurance? If so, how much can I expect to pay?
  5. Is my therapist contracted on your panel? If not, what are my out of network benefits?
  6. Do I need an authorization? If so, what is the number and how many sessions does it cover?
  7. How many sessions are covered per year?

Important: Verification of benefits does not guarantee payment. You will be responsible for unpaid/denied insurance claims. Insurance does not cover missed sessions. You will be responsible for all missed appointments and cancellations without 24 hour notice at our full rate.

Print the questionnaire

Professional Referrals


Natasha Sane, M.D.
Child, Adolescent, and Adult Psychiatry
16311 Ventura Blvd.
Suite 1050
Encino, CA 91436
Limited office hours in Westwood


Barry Cohen, Ph.D.
9777 Wilshire Blvd.
Suite 507
Beverly Hills, CA 90212

Scottie Davis, Psy.D.
11911 San Vicente Blvd. 
Suite 270
Los Angeles, CA 90049

Scott O. Haris, Ph.D.
11980 San Vicente Blvd
Suite 710
Los Angeles, CA 90049

Barbara Wilson, LMFT
11911 San Vicente Blvd.
Suite 270
Los Angeles, CA 90049

Other Professionals:

Gallop Creative
Graphic and Web Design
Amy Savarese