Complete the Intake Process

Once directed by administrative staff, please fill out the CCG Intake Information Form directly below.  You will need the following handy in order to complete this form in one sitting: Insurance information (if using), including the subscriber/member’s address and date of birth; Primary Care Physician (if you have one).​

Once that is complete, follow the directions afterward to ensure your intake process is finished.

What to expect next ...

Once you have filled out the CCG Intake Form, we will send you an email from which will prompt you to create a Client Portal. Inside your portal account you will complete the following:

Patient Information Form—fill out and submit

Covid Policy—Read and e-sign (this is particularly important to know when you come into the office for an in-person visit as it outlines the very specific procedures to follow.)

Intake Information Form (the form you filled out previously above)—confirm information and e-sign

Insurance Card FRONT—upload a picture. (If you have more than one insurance, take a picture of all cards together in the order they should be processed–primary at the top, then secondary, then–if applicable–tertiary.)

Insurance Card BACK—upload a picture. (Take a picture of the back of all applicable cards together the same as was done for the fronts.)

Driver’s License FRONT/BACK–upload a picture of each side of your license in the same way you did for your insurance card