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    At this time we only accept clients paying out of pocket or through Medi-Cal. If you are a Medi-Cal client, please let us know on this form. We only accept Medi-Cal through the Partnership Program of California, administered by Carelon Behavioral Health Strategies, but NOT through Kaiser or Value Options programs. We do not accept any other types of insurance or EAP’s directly, but if you are paying out of pocket we can provide a statement for you to submit for insurance reimbursement.

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    (Submitting this form will generate an email sent to Petaluma Family Therapy staff. By submitting this form, you acknowledge that email is not a secure form of communication, and while unlikely, any emails may be intercepted and read by third parties.)