New Therapy Patient Registration
Thank you for registering online to become a new patient. If you are coming in as a couple, we are requesting that each of you complete the registration process. Please register, for both couples and individuals, only after speaking to Dr. Thorpe and an appointment has been scheduled. Providing this information prior to your initial session helps us better focus your appointment time and eliminates errors in entering your information in our system. The security and privacy of your information are very important to us.
Here is the seven-step process to register:
- Click on the link at the bottom of this page and you’ll be directed to a form where you can type in your information. Your cell phone number and e-mail address are required.
- If you’d like us to submit forms to your insurance company for reimbursement, please type in the information. Also, upload the front and back of your insurance card by using the “ID Card” button in the top left. For couples, only upload the insurance information for the partner that you are selecting to be considered the identified patient by your insurance company. All of the appointment information, including a diagnosis, will be submitted under this partner only as per insurance policy. If you’re having difficulty, please take a picture and email it to us. (Note: Dr. Thorpe is out-of-network for all insurance plans.)
- Therapist-Patient Agreement: Please read and sign the last page of this document. If you’re coming in with someone 14 years of age or older, have them sign as well. When we meet, I’ll explain this document in detail. If you’d like a copy, please click on this link.
- Authorization for Release Form: If you’re working with a psychiatrist or other healthcare professional with whom you’d like me to coordinate care, please fill out this form.
- Since we may be meeting via Zoom, please read and sign the Internet Therapy Consent Form.
- Please provide your credit card information by filling out this form. We’ll keep your credit card on file and charge it after each session. Under amount, please write in “open for $200/45mins; $250/60 mins”.
Note: Appointments are typically 45 minutes, at a rate of $200. Alternatively, you may request a 60-minute session, which costs $250. Please be aware that actual clinical time is under the allotted appointment time, as is standard in the field.
- Good Faith Estimate: Please indicate whether this process applies to you or not and if so familiarize yourself with the details in the document.
The No Surprises Act prevents patients from receiving surprise medical bills. Under the law, health care providers are required to give patients who don’t have insurance or who are not using insurance an estimate of the bill for medical items or services called a Good Faith Estimate. This does not apply to patients who use their out-of-network insurance benefits for reimbursement. (Dr. Thorpe is an out-of-network provider for all insurance plans.)
- New Jersey Notice: Notice of Policies and Practices to Protect the Privacy of Your Health Information. Please read by clicking on this link.
Address/Parking/Building – click on this link
Please Click Here to Start the Registration Process
You will receive Registration Submitted Successfully if your info went through.
To ensure this please hit Save & Continue for all of the forms, even if you are not signing them and turn off your pop up blocker so that you get error messages directing you to fill out needed information.
20 Community Place
Some tips for parking and entering the building:
- Community Place is a one-way street two blocks from the square in the center of town. It is just off of South St., which is the main street.
- Most street parking is metered, so please bring quarters. Some spots take credit cards. They do ticket so watch your time.
- Take the elevator or stairs to the 4th floor, our office suite.
Note: the elevator is very slow.
- No need to check in, just take a seat in the shared waiting room and you’ll be greeted at your appointment time.
- Allow extra time for your first visit, as the office is located in a busy section of town.
- Masks may be required in the building and waiting room.