Marshall Campbell Professional Credentials:Student Therapist at MidAmerica Nazarene UniversityMaster of Arts in Counseling (in progress) Get Started with Marshall Will this appointment be for you or are you making a referral for someone else? * Myself Minor under my care I am making a referral for someone Client's Name * First Name Last Name Your Name (if different than Client's Name) First Name Last Name Phone Number for Scheduling Contact * (###) ### #### Email for Scheduling Contact * How do you prefer to be contacted? * Email may get a faster response. Please check your Spam/Junk folder for our confirmation email. Phone Call Email Which location would you prefer to be seen at? (check all that apply) * Leavenworth, KS Liberty, MO Olathe, KS Overland Park, KS Ottawa, KS Online/Telehealth Do you plan to use Insurance or Self-Pay? Please choose your insurance from the list. * Aetna Aetna Better Health of Kansas (KS Medicaid) Ambetter Blue Cross Blue Shield of Kansas Blue Cross Blue Shield of Kansas City Cigna / Evernorth Multiplan Sunflower Health Plan (KS Medicaid) Tricare United Healthcare United Healthcare Community Plan (KS Medicaid) UMR Employee Assistance Program I do not have insurance or will not be using insurance Do you have a secondary insurance? If yes, which insurance? * I do not have a secondary insurance policy. Aetna Aetna Better Health of Kansas (KS Medicaid) Ambetter Blue Cross Blue Shield of Kansas Blue Cross Blue Shield of Kansas City Cigna / Evernorth Multiplan Sunflower Health Plan (KS Medicaid) Tricare United Healthcare United Healthcare Community Plan (KS Medicaid) UMR Employee Assistance Program I do not have insurance or will not be using insurance Which service(s) would you like to receive? * Affordable Counseling Services Anxiety Treatment Brainspotting Couples Therapy DBT Therapy Depression Treatment EMDR for Children EMDR & Trauma Treatment First Responders Family Therapy Internal Family Systems Play Therapy Somatic Experiencing Therapy Therapy for Teens Veterans Other How did you hear about us? * Church Facebook / Instagram Friend or Family Member Google Search I'm a Current or Previous Client Insurance Provider Law or Court Recommended / Ordered Fortis Employee Psychology Today Referred by Doctor or Another Agency Social Services School Other By clicking I WANT TO GET STARTED, you are giving us permission to email you. You may opt-out at anytime. Thank you!
