Please download and complete the following forms and email them to me at Mark@MarkDeyabLICSW.com. Also take a photo of the front and back of your health insurance card and email both sides of the card to me. Please pay your co-pay after each session by check, Zelle (7817993949) or Venmo (@Mark-Deyab).

• Patient Info

• Cancellation Policy

• HIPPA

• Policy Agreement

New Way for New Patients to become a patient of

Mark Deyab manages his psychotherapy practice by using an all-in-one software system and portal which is the hub from which all business and activities are conducted: all communication, video calls, scheduling and making co-payments. The portal allows for private messaging, the capacity for patients to make appointments and the option to upload credit card information so co-payments can be managed by Mr. Deyab.

In order to become a new patient, interested parties need to contact me via phone, text or email and let me know the following: briefly what issues you would like to address in counseling, what type of health insurance you carry, your ability to do telehealth meetings during business hours and any particular days and times that you are available.