KUNA COUNSELING CENTER
  • Home
  • Telehealth
  • Forms / Resources
  • Services
    • Individual counseling
    • Children and Adolescent Counseling
    • Family Counseling
    • Marital, Premarital, Divorce, and Couples Counseling
    • Community Based Rehabilitation Services (CBRS)
    • Peer Support
    • Developmental Disability Services for Children
  • Counselors & Staff
    • Counselors >
      • Jim Grigg, LCPC,LMFT, Clinical Director
      • Angie Brewster
      • Dawn Toth, LCPC
      • Erin Fischer, LPC
      • Jennifer Seegmiller
      • Lisa Nestler
      • Marie Breton
      • Bethany Townsend
      • Sam Clemens
      • Stacey Balla
    • Interns >
      • Melinda Hill
    • Community Based Services >
      • Respite >
        • Stacey Balla, Program Manager, CBRS, CM, CPSS
        • Felisha Hillyard, CPSS
        • Amber Romero, BA
        • Morgan Buhr, BA
        • Ryleigh Swagerty, BA
        • Jessica Stoddard, BS HI
        • William Headley, BS
        • Keri Sengsourinho, BS
        • Rachel Alegria, BS
        • Baylee Critchlow, BA
        • Kayla Thomas
        • Brittany Raymond
      • CBS >
        • Stacey Balla, Program Manager, CBRS, CM, CPSS
        • Morgan Buhr, BA
        • Erin Ogden
        • Ryleigh Swagerty, BA
        • Jessica Stoddard, BS HI
        • Keaira Thompkins
        • William Headley, BS
        • Keri Sengsourinho, BS
        • Baylee Critchlow, BA
      • Case Management >
        • Stacey Balla, Program Manager, CBRS, CM, CPSS
        • Amber Romero, BA
        • Ryleigh Swagerty, BA
        • William Headley, BS
        • Keri Sengsourinho, BS
      • Peer Support >
        • Stacey Balla, Program Manager, CBRS, CM, CPSS
        • Felisha Hillyard, CPSS
      • Behavioral Interventionist >
        • Jessica Stoddard, BS HI
    • DD Services Employees >
      • Nicholle Bouvier
      • Madison Wheeler
      • Nicole Openshaw
      • Lonnie Fitch
      • Maria Ortiz
    • Office Staff >
      • Nancy Sluder, Office Manager
      • Maxine Nell
      • Leslie Cleere
      • Sam Rasmussen
      • Bernadette Martinez, Assistant Office Manager
      • Claudia Barton
  • Payment Info
    • Insurance Information
    • Medicaid
    • Cash & Credit
    • Discounted Services & Sliding-Fee Scale
  • Insurance/Cash Pay Forms
  • Medicaid Forms
  • Additional Resources

​Medicaid Forms

Client Information Sheet: 
http://media.virbcdn.com/files/7b/6932c9c6f4f9c1b8-01_Insurance-InformationSheet.doc
Missed Appointment Form: 
https://www.dropbox.com/s/1bjvkljlrblbiik/004%20Missed-Cancelled%20Appointment%20Policy%203-21-19.doc?dl=0 
Client Rights: 
http://media.virbcdn.com/files/ba/8a14216ccf6ee76b-03_ClientRights1-06-09.doc
Grievance Form: 
http://media.virbcdn.com/files/2e/c4204bd2ff43c713-04_GrievanceProcedureForm.doc
Questionnaire: 
http://media.virbcdn.com/files/43/f7fe78f348680727-06_QuestionnaireOfficial2-6-07.rtf
Health and Physical: (Please add doctors name to "from" section)  
http://media.virbcdn.com/files/a5/553b09d773955629-07_ROIHealthandPhysical.doc
Facilty Fee: 
http://media.virbcdn.com/files/c1/0061ff62fc5600ca-08_FacilityFeesFormFinal6-16.docx
Medicaid Requirements: 
http://media.virbcdn.com/files/e7/57037a491ce4d2c9-10_ReviewRequirerments.doc

We thank you for taking the time to fill out our forms prior to your appointment. Please print forms to bring with you to your scheduled session as well as your insurance card. 

If you have any questions please call our office at 208-922-9001.

Contact Us:

145 E. Deer Flat Rd. Kuna ID, 83634 
             Phone: 208-922-9001
Fax: 208-922-3778
  • Home
  • Telehealth
  • Forms / Resources
  • Services
    • Individual counseling
    • Children and Adolescent Counseling
    • Family Counseling
    • Marital, Premarital, Divorce, and Couples Counseling
    • Community Based Rehabilitation Services (CBRS)
    • Peer Support
    • Developmental Disability Services for Children
  • Counselors & Staff
    • Counselors >
      • Jim Grigg, LCPC,LMFT, Clinical Director
      • Angie Brewster
      • Dawn Toth, LCPC
      • Erin Fischer, LPC
      • Jennifer Seegmiller
      • Lisa Nestler
      • Marie Breton
      • Bethany Townsend
      • Sam Clemens
      • Stacey Balla
    • Interns >
      • Melinda Hill
    • Community Based Services >
      • Respite >
        • Stacey Balla, Program Manager, CBRS, CM, CPSS
        • Felisha Hillyard, CPSS
        • Amber Romero, BA
        • Morgan Buhr, BA
        • Ryleigh Swagerty, BA
        • Jessica Stoddard, BS HI
        • William Headley, BS
        • Keri Sengsourinho, BS
        • Rachel Alegria, BS
        • Baylee Critchlow, BA
        • Kayla Thomas
        • Brittany Raymond
      • CBS >
        • Stacey Balla, Program Manager, CBRS, CM, CPSS
        • Morgan Buhr, BA
        • Erin Ogden
        • Ryleigh Swagerty, BA
        • Jessica Stoddard, BS HI
        • Keaira Thompkins
        • William Headley, BS
        • Keri Sengsourinho, BS
        • Baylee Critchlow, BA
      • Case Management >
        • Stacey Balla, Program Manager, CBRS, CM, CPSS
        • Amber Romero, BA
        • Ryleigh Swagerty, BA
        • William Headley, BS
        • Keri Sengsourinho, BS
      • Peer Support >
        • Stacey Balla, Program Manager, CBRS, CM, CPSS
        • Felisha Hillyard, CPSS
      • Behavioral Interventionist >
        • Jessica Stoddard, BS HI
    • DD Services Employees >
      • Nicholle Bouvier
      • Madison Wheeler
      • Nicole Openshaw
      • Lonnie Fitch
      • Maria Ortiz
    • Office Staff >
      • Nancy Sluder, Office Manager
      • Maxine Nell
      • Leslie Cleere
      • Sam Rasmussen
      • Bernadette Martinez, Assistant Office Manager
      • Claudia Barton
  • Payment Info
    • Insurance Information
    • Medicaid
    • Cash & Credit
    • Discounted Services & Sliding-Fee Scale
  • Insurance/Cash Pay Forms
  • Medicaid Forms
  • Additional Resources