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PRE-REGISTER

We accept all commercial insurances including Aetna, Cigna, UPMC, United Healthcare, and Blue Cross Blue Shield. We also accept Highmark Wholecare, Medicaid & Medicare. Don't see your insurance listed? Give us a call.

If you are experiencing a crisis please call Re:solve Crisis Network at 1-888-796-8226 or 988 (suicide or crisis hotline)

Thank you for contacting Persad Center. If you are interested in accessing our services, please fill out the pre-registration form below. This form will allow us to obtain some information about you, what your needs are, and what your previous experiences have been with mental health treatment.

One of our Intake Coordinators will contact you via email within 2 business days to discuss the next steps in your registration process.

Pre-Registration Form

Contact Information:

Full Name

Date of birth

Phone

Pronouns

ZIP code

Brief description of your need for services:

description

Have you completed a higher level of care in the last 60 days (Psych Hospital, Partial or IOP)?

Yes

If Yes, describe.

Are you looking for:

Mental Health Treatment

Substance Use Treatment

Dual Diagnosis Treatment

Are you currently in therapy?

Yes

What kind of services are you looking for?

Individual therapy

Psychiatric services

Both

Is this for a court ordered assessment?

Yes

Is this for a pre-surgical mental health evaluation?

Yes

Do you have health insurance?

Yes

If Yes, list insurance provider

Provide Subscriber ID (found on card)

Provide Group Number (found on card)

If No, please visit www.compass.state.pa.us to apply.

How did you hear about Persad Center?

Word of mouth, website, referred by your doctor, ad, mailing, etc.

If you have any questions, please give our intake department a call at 412-441-9786 extension 252

By choosing this option, you have agreed to share your information with Persad Center. The information contained in this transmission is privileged and confidential and/or protected health information (PHI) and may be subject to protection under the law, including the Health Insurance Portability and Accountability Act of 1996, as amended (HIPAA).