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GIA Institute of Psychotherapy

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What is your health insurance status? Please upload your insurance card iif you have it.

I have health insurance through work I pay for health insurance myself I have NJ Family Care, Medicare, or Mecicaid I don't have health insurance

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Please check all that apply to you or to the person seeking services:

I will only see a clinician who takes my insurance. I will be paying out-of-pocket. I just want to see a therapist who is the right fit, regardless of insurance. I am a public school teacher, firefighter, police officer. I work for a municipality, county, or for the state of New Jersey. I would be interesting in seeing a graduate intern at a reduced fee.

Name of Primary Insured/Subscriber:

Date of birth of Insured/Subscriber:

Relationship to Insured/Subscriber:

Address of Insured/Subscriber:

please include full address and 9 digit zipcode

If you receive your insurance through work, who is your employer:

For medical emergencies, contact your healthcare provider or call 911. For mental health crises, call or text 988.

GIA Institute of Psychotherapy

609.788.0771 |

Somers Point

Main Location

Somers Point, NJ 08244-2553

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THE CLIENT PORTAL IS NOT TO BE USED FOR EMERGENCY SITUATIONS. IF YOU OR OTHERS ARE IN IMMEDIATE DANGER OR EXPERIENCING A MEDICAL EMERGENCY, CALL 911 IMMEDIATELY.