RESOURCES
Important Links
If you are in crisis or feeling suicidal. Please call the 24-hour crisis line numbers. For King Co 206-461-3222. For Snohomish Co 800-584-3578. For emergency, please call 911 or go to the nearest emergency room.
Alcohol Addiction
Borderline Personality
Domestic Violence
National domestic violence hotline
Mental Illness
Suicidal Thoughts
PTSD Self-Test

information
Faqs & Policies
What is the procedure?
Step 1.
Fill out and submit a form here to schedule an appointment
Step 2.
After submitting the form, you may schedule an appointment directly. We require an additional questionnaire for medical history and completion of Consent form.
Step 3.
If treatment is issued, we can arrange to have it shipped to your doorstep. Or, if you prefer picking it up at a local pharmacy, you may ask your provider to send it there by providing the name, phone number, and address of the location.
Where do I send the forms?
After completing the forms simply email to pcmhclinic.ga@gmail.com or fax them to 877-600-8393. Once the forms are received and credit card confirmed you will receive an email with your Doxy link for your appointment.
This is to ensure payment of any Copay, Coinsurance or deductible that is due at time of service.
If you have secondary insurance and eligibility has been confirmed then a credit card authorization is not required.
Billing Fees
We expect that fees will be paid in full at the time of service. Any account balances will be paid within 30 days of receiving a statement from us. We will turn over unpaid accounts to collections. We reserve the right to refuse to reschedule appointments if account balances are not paid.
Appointments
Please be sure to call 24 hours (1 business day in advance) to cancel or reschedule your appointment. This includes making a same day appointment and later canceling or rescheduling. If you need to cancel, reschedule, or make an appointment, please call during business hours, as our answering service does not take messages after hours regarding appointments & non-emergency calls about appointments. There is a $50.00 No Show fee. If you feel you have an emergency situation, please dial 911. If there is no call to notify the office that you will be cancelling and you fail to show for your first appointment, we may not be able to schedule you back in to be seen right away, thus, a longer wait time may occur.
Our office utilizes an automatic reminder message that allows you to confirm or cancel your provider’s appointment, so please make sure that we have your most recent telephone number on file so that you receive the reminder call.
Appointment reminder calls are attempted as a courtesy for you, but it is your responsibility to keep track of appointment dates and times. There is a $75.00 charge for no show appointments, or visits that are canceled/rescheduled on the day of the appointment. If you miss (3) appointments, you will be discharged from PCMH Clinic Team.
Please be sure to make a follow up appointment after seeing the provider to ensure that you get in within a timely fashion to renew your prescriptions. We highly recommend making an appointment BEFORE you leave the office, or the following day, as schedules tend to fill up rather quickly.
Prior Authorization for Medication
Many insurance companies require prior authorization on certain medications. Please have your pharmacy fax the notification to our office and we will respond to the request from your insurance company. Keep in mind that prior authorization requests can take from 2-5 business days to process after we send the information to your insurance carrier. PCMH Clinic Team is not responsible for your insurance company’s decision of whether or not they will cover your medication.
If you are seeking help with access to medications through a special program; ( i.e. patient assistance), we will provide the prescription to you.
Letters & Forms
If you are requesting a letter to be written on your behalf or forms to be completed, please keep in mind that your request will take 3+ business days to complete. Our medical provider must approve and sign all letters before they can be picked up/mailed/faxed. The minimum turn around time for letters is one week, so please request them 1-2 weeks in advance. Fees for providing written documentation, filling out forms, letters, etc. start at $25 and increase due to the complexity of the communication.
Disability Claims
If you are requesting assistance in completion of a disability claim, please make note of the following:
****Short Term Disability and FMLA Paperwork ONLY! We do not process paperwork or evaluate for Social Security Disability! ****
- PCMH Team does not “give” disability. We can only report symptoms and response to treatment to the company that handles your disability insurance.
- We do not backdate disability.
- If regularly scheduled appointments are not kept, we will notify your disability carrier.
- Our providers’ first priorities each day are to see scheduled patients; therefore, they will complete letters and forms as time permits. Disability paperwork requests take 7 to 10 business days to complete.
How safe am I with you?
PCMH Clinic is a safe place for you to talk with the following expectations, rules and regulations being met:
- If you ever communicate current suicidal or homicidal intent, you have to be reported so further help can be given.
- If you ever communicate sexual physical or mental abuse in any way about a minor, elderly or developmentally delayed person, due to mandates by law, you have to be reported.
- If you choose bring someone with you, during your session, if you are non-verbally or even verbally consenting to their presence.
- If you do anything to break trust related to prescribing authority, PCMH Clinic has the right to terminate your relationship.
documentation
Patient Forms
About
PCMH Clinic provides customized compassionate care for all.
Hours
Mondays through Friday
Open 9:00am - 5:00pm