ASTRA Forms

Our forms needed for treatment are located below. Please feel out these forms and bring them with you to your appointment.

• Beck's Depression Inventory


• Authorization to Release Protected Health Info.


• NICHQ Vanderbilt Assessment Scale


• Screen for Child Anxiety Related Discorders (Child)


• Screen for Child Anxiety Related Discorders (Parent)


• Referral Form


• Telehealth Consent Form


• New Patient Registration Forms


• Demographic Update Form 2021

Insurance Companies we Accept

• Anthem
• Tricare
• Humana
• Aetna
• UBH/Optum
• Cigna
• Value Options
• Bluegrass Family Health
• Mail Handlers
• UMR
• Gateway Health
• Medicare
• Medicaid
• Passport
• Humana Care Source
• Anthem Medicaid

*This list changes often; if you don’t see your insurance listed please give us a call to see if we might be in network.