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deBussy and Associates Behavioral Health

3661 Wrangle Hill Rd, Bear, DE 19701
(302) 722-5261

Contact Us - New Patient

 

Use the form below to contact us if you are interested in becoming a new patient. This is a secure website, and all information will be kept confidential.

All consent forms and most communication is handled through a patient portal, email, and text. You must have an email address that you actively check.

Patients who are perinatal (trying to conceive, pregnant, or postpartum) are accepted.

Only patients between ages 18 and 64 are accepted.

Please review the list of Accepted Insurance before completing the form below. If your insurance is not accepted, you may pay for your treatment and work with your insurance company to get reimbursed.

Insurance eligibility and benefits will be verified by our office.

*First Name:
La
Date of Birth:
Treatment needs:
   Anxiety:
   Bipolar:
   Depression:
   Panic:
   PTSD:
 
Stage of conception:
Current prescriber:
Current therapist:
Referred by:
 
Primary insurance:
Member ID:
Secondary insurance:
Member ID:
 
 
Security Check - Enter the numbers spelled below without spaces. For example Three One Two One Five would be entered as 31215

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