KUNA COUNSELING CENTER
  • Home
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  • 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 >
      • Bethany Townsend (PhD, LCPC, NCC)
      • Dawn Toth, LCPC
      • Dawn Marie Kangas, LPC
      • Jim Grigg, LCPC,LMFT, Clinical Director
      • Kelsey Willbur, LPC
      • Kerri Mosley, COUI
      • Lisa Nestler LPC
      • Marie Breton, LMFT
      • Sarah Hessing, LCSW
      • Viola Nhapi, LPC
      • Todd Harris, COUI
    • Interns >
      • Kyle Hackett, Counseling Intern
      • Jace Hudon, Counseling Intern
    • Community Based Services >
      • Respite
      • CBS
      • Case Management
      • Peer Support
      • Behavioral Interventionist
    • DD Services Employees >
      • Nicholle Bouvier
    • Office Staff >
      • Nancy Sluder, Office Manager
  • 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 >
      • Bethany Townsend (PhD, LCPC, NCC)
      • Dawn Toth, LCPC
      • Dawn Marie Kangas, LPC
      • Jim Grigg, LCPC,LMFT, Clinical Director
      • Kelsey Willbur, LPC
      • Kerri Mosley, COUI
      • Lisa Nestler LPC
      • Marie Breton, LMFT
      • Sarah Hessing, LCSW
      • Viola Nhapi, LPC
      • Todd Harris, COUI
    • Interns >
      • Kyle Hackett, Counseling Intern
      • Jace Hudon, Counseling Intern
    • Community Based Services >
      • Respite
      • CBS
      • Case Management
      • Peer Support
      • Behavioral Interventionist
    • DD Services Employees >
      • Nicholle Bouvier
    • Office Staff >
      • Nancy Sluder, Office Manager
  • Payment Info
    • Insurance Information
    • Medicaid
    • Cash & Credit
    • Discounted Services & Sliding-Fee Scale
  • Insurance/Cash Pay Forms
  • Medicaid Forms
  • Additional Resources