Start Therapy/Forms

Please Complete The Following Steps To Successfully Initiate Services:

  1. Contact your insurance company to verify with your insurance company if there would be coverage for the services your child needs. Questions to ask include:

    • If there is coverage, are there any exclusions?
    • Do I have a neuro-developmental benefit?
    • Do I have a co-payment or is there a percentage of the bill I will be responsible for?
    • Does my plan require a deductible be paid for the calendar year before the coverage begins?
    • Does my insurance plan cover only a limited number of sessions for each calendar year?
    • Is there a requirement that I get a prior authorization and/or a referral/order from my physician before I see a clinician?

  2. Obtain order/referral from your child's physician if you haven't already.

  3. For more info about Psychological / Mental Health Services, schedule a phone meeting with a member of our team.

  4. For more info about Behavioral Health Services, schedule a phone meeting with a member of our team.

  5. For more info about our Skill Builders Preschool Program, email

  6. For more info about our Social Skills Programs, email

  7. To start the intake process for Psychological / Mental Health Services, complete the appropriate forms below and email, fax or mail the forms back to MOSAIC Children's Therapy.
    • Email: Melissa Badenna
    • Fax: (425) 732-4606
    • Mail: 13010 NE 20th St, Suite 300, Bellevue, WA, 98005

Note: Your intake forms and any other requested information must be received no later than one week before your scheduled appointment.

Available Forms: