This facility is a member of the National Health Service Corps: NHSC.hrsa.gov

Crosspointe Family Services

(208) 736-7090

  • Home
  • Behavioral Health
  • Paperwork/Payment Methods
  • Patient Portal
  • About Us
  • Contact Us
  • Resources
  • Human2Human
  • Careers
  • More
    • Home
    • Behavioral Health
    • Paperwork/Payment Methods
    • Patient Portal
    • About Us
    • Contact Us
    • Resources
    • Human2Human
    • Careers

(208) 736-7090

Crosspointe Family Services
  • Home
  • Behavioral Health
  • Paperwork/Payment Methods
  • Patient Portal
  • About Us
  • Contact Us
  • Resources
  • Human2Human
  • Careers

New Client PAPERWORK AND Client FORMS

Register on our Patient Portal and click on the "Application" link to submit new client paperwork.

See below for additional Client Forms not available on our portal.

New Patient Demographics and History (pdf)Download
General Informed Consent and Client Rights (docx)Download
Blank Release of Information (docx)Download
Consent to Treatment For Minors (docx)Download
Your Rights and Protections Against Surprise Medical Bills (For Private Ins./Private Pay Client) (docx)Download
OPTUM Rights and Responsibilities (For Optum Clients Only) (docx)Download
ICANS Informed Consent Form (For Optum Clients under 19) (pdf)Download
DSM-5 Self Rated Level 1Crosscut - Adult (pdf)Download
DSM-5 Self Rated Level 1 Crosscut-Teen 11-17 (pdf)Download
Sliding Fee Application (pdf)Download
Payment Plan Agreement (docx)Download
CC on file/Payment Agreement (xlsx)Download
GAIN Assessement Agreement (pdf)Download

Methods of payment

Cash, Check, or Charge: Easy Ways To Make Payments

 Use Visa, Mastercard, debit cards, checks, or cash to pay for appointments or fees at Crosspointe Family Services. For your convenience, we also have a self-pay rate and a sliding fee schedule. 

Submit Credit Card Payment

We accept most insurance plans

  • Aetna
  • Beacon Health
  • Blue Cross of Idaho
  • Blue Cross Medicare Advantage
  • Blue Cross Secure Blue
  • Blue Cross True Blue
  • Bright Path
  • Business Psychology Associates
  • Evernorth
  • Coventry
  • First Choice Health
  • First Health Network
  • Idaho Medicaid
  • Idaho Physician’s Network
  • Medicare
  • Mountain Health Co Op
  • MultiPlan
  • Pacific Source Commercial Plans
  • Pacific Source Medicare Plan
  • Regence Blue Shield
  • Select Health
  • Tricare
  • Triwest
  • University of Utah Healthplans
  • United Healthcare
  • Uprise Health

Here for you.

Are you ready to get on the path to a healthier you? Get in touch today to get started!

Contact Us

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