Connect with Services - Solvista Connect

Is this a crisis and do you need to be connected to someone right away?*
- Yes
- No
Are you having thoughts about taking your own life or hurting someone else?*
- Yes
- No

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We would like to connect you to a provider that will be a great match and best able to meet your needs. Please provide some information about why you are interested in our health services (all information is kept secure and confidential).
Why you are interested in seeking care?*
- Anxiety
- Relationships
- Depression
- Medication
- Challenges with my kid(s)
- General support
- Substance abuse
- Other
Provide more detail in a few sentences if you would like:
Is there anything you want your therapist to know about you?
Is there anything you are looking for in a therapist?

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We are always looking for ways to make it easier for people to start care with us.
How did you discover SolvistaConnect?*
- Friend/family member
- Another provider
- Social media ad
- Internet search
- Newspaper ad
- Solvista Health Employee
- Other

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Many people have had fewer barriers and better outcomes to their care when they participate in telehealth services from the comfort of their own home. Others prefer to be seen in-person in the office setting. We have found that telehealth services work best on a webcam enabled device with either at least 4G service or a cabled internet connection.
Are you interested in receiving services using telehealth?*
- Yes
- No
- Maybe, I’d like more information

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We would like to know when you are available so we can provide some options to get connected to one of our treatment teams.
When are you most typically available?*
- Mornings (8am – 1pm)
- Afternoons (12pm – 5pm)
- Evenings (5pm – 7pm)
Are there any days that work especially well for you?
- Monday
- Tuesday
- Wednesday
- Thursday
- Friday

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We know that reaching out for care can be difficult, and not knowing the costs can add to that stress! We never want payment to stand in the way of treatment. Please provide some information about your insurance or needs to help us provide you with accurate info at your first appointment. This will help us match you with a therapist who is covered by your insurance.

We accept a variety of insurances including Medicaid, Medicare and Private Insurance.
Please let us know if you will be using one of the insurance options listed below:*
- Colorado Medicaid (Health First Colorado)
- Medicare
- I do not have insurance and would like information about other options for payment
- Private insurance
Private insurance information (optional)
Name of provider
This information will expedite our ability to verify your insurance and identify provider options
Group ID
Medicare information (optional)
Policy number
This information will expedite our ability to verify your insurance and identify provider options

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Thank you for contacting us and sharing your needs and desires for behavioral health services. To get started on your journey and connect with our services, click “Submit.”

In accordance with our privacy policy

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