New Patient Appointment Details

Please complete the form below, including the requested insurance information. If you are not using health insurance, you may enter N/A in these fields. Once submitted, a Clear Skies intake coordinator will be in touch to confirm your appointment.

If you have any questions, please contact our office at (310) 943-9675.

Name

First Name

Last Name

Phone

Name of person scheduling appointment (if different from patient)

Patient Date of Birth

Patient Insurance Provider

Patient Insurance ID Number

Treatment Rationale (Optional)

Preferred Appointment Days/Times

Preferred Counselor(s)

SCHEDULE ONLINE

Clear Skies Psychology offers online appointment scheduling for new patients. Schedule a new appointment now.

ABOUT

Clear Skies Psychology was established in 2011 when a small group of independent counselors who enjoyed working with children and families decided to open an office together. Since then, Clear Skies has helped hundreds of children, families, and adults live happier, more satisfying lives and we look forward to helping you too.