Step 1 of 5

  • Patient Registration

  • Insurance Card

  • Additional Insurance Information

  • If no please complete the following
  • Credit Card Information

  • Credit Card Authorization

  • I, authorize 1-View Psychiatric NP & Behavioral Therapy PC, to charge my credit card for agreed upon service(s) and/or cancelation fee(s). I understand that my information will be saved to file for future transactions on my account.