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Telehealth Policies

 Skycloud Mental Health offers video appointments to individuals in the states in which the health care provider is licensed (updated on website). Patients must be located in one of these states at the time of the appointment but otherwise may be at any private location of their choice for the appointment. Video appointments require access to a device with audio and video capabilities as well as internet connection. Insurances may not cover video appointments. Pricing is posted here.

Sessions and visits will be held via “telehealth”: using video conferencing software with audio capability and/or a separate software/device for audio (e.g, telephone, headset, etc.). Of note, telehealth establishes a formal provider-patient relationship used to maintain regular assessment, diagnostics, therapy, and/or prescription. We will be utilizing Health Insurance Portability and Accountability Act (HIPAA) protected software to ensure that your protected health information is secure from unauthorized access and that confidentiality is maintained. This document serves as a consent form for treatment via telehealth in general.

Benefits of Telehealth

Telehealth stands at the crossroads of cutting-edge technology and formal health services. You can expect the following benefits:

  • Telehealth eliminates barriers to accessing healthcare and provides an alternative means to obtain behavioral health services for patients who may otherwise have limited accessibility or encounter prolonged waiting lists in the community.
    In addition to removing the burden of travel time to a physical medical office as well as the risks and costs associated with transportation,
  • Telehealth allows for flexible scheduling.
  • Telehealth offers a reduction of stigma by providing private treatment in the comfort of the patient’s personal space.
  • Telehealth can provide treatment to patients with disabilities and limited mobility without requiring extensive planning for transport.

Limitations of Telehealth

While it is not possible to anticipate all the limitations of any treatment, you should consider the following when consenting to treatment via telehealth:

  • Telehealth audio visual equipment may experience technical difficulties.
  • While every precaution is taken to secure patient data and maintain confidentiality, the nature of electronic appointments results in additional exposure to security breaches.
  • Telehealth may not be suitable for certain illnesses that require higher levels of care.
  • Certain illnesses may not be adequately treated by telehealth.

 

We reserve the right to assess suitability and appropriateness of telehealth candidates due to the potential limitations of the treatment modality mentioned above.

 

As telehealth is generally conducted remotely, safety protocols and alternate means of seeking help will be addressed in detail in your consultation. However, the following are generally accepted alternatives to treatment via telehealth: Treatment in a more traditional, in-office visit with another provider. Pursuing treatment via telehealth is a decision made by you. If you choose to revoke your decision and pursue alternate treatment, you are able to withdraw your consent at any time. (Of course, we recommend discussing this decision with your provider first. We also recommend establishing your next provider prior to termination to eliminate any gaps in treatment.). By signing this form I certify that I:

  • I understand that I am consenting to evaluation and treatment via telehealth.
  • I understand that no results can be guaranteed, despite our best efforts to deliver care.
  • I have been given the opportunity to ask questions about telehealth or any aspects of the evaluation and treatment at any time.

 

 

 

Holistic Psychiatric Treatment
at Home in OR, WA, UT, MN, AZ, NM, and NV

Evidence-based mental
healthcare at Skycloud

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503-694-3381

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Do you prefer to register online or by phone?

I understand that only the patient or their legal guardian should complete this form.

I am the:

The potential patient, or their parent/guardian, must fill out this form. Identification will be requested during the process. If they are not available, please direct the potential patient to this page at a later time. Health care providers can find referral information here.

We are taking patients ages 13-17 with certain specified insurance panels in OR, WA, and UT. “You” in the following slides refers to the potential patient.

Are you seeking psychotherapy, medication management, or another evaluation type?

We are currently accepting new clients for psychiatric evaluations. Our psychotherapy caseload is full but you can contact us to learn more and join the waitlist.

Contact Us

Our psychotherapy caseload is full. Patients in OR, WA and UT can join our waitlist by clicking the button below.

Learn more about psychiatric evaluations, which can help you determine a treatment plan. Call us at 503-694-3391 or email admin@skycloudhealth.com with any questions.

Limitations of Skycloud:

  • – We do not offer evaluations for disability or legal reasons.
  • – Opioid use disorder treatment is only offered in Oregon, Washington, and Utah.
Resources

Have you attempted suicide in the past?

When was your most recent suicide attempt?

Unfortunately we do not have clinicians who are able to treat you via telehealth at this time. Please contact clinic at (503) 694-3381 with questions and check our list of resources.

See Resources

Have you ever been hospitalized in a psychiatric unit or stayed in a residential mental health facility?

When was your most recent hospitalization or stay in a residential mental health facility?

Where do you reside?

We are only offering services in Oregon, Washington, Utah, New Mexico, Arizona, Minnesota, and Nevada at this time.

See Resources

Are you currently prescribed a stimulant (e.g. Adderall, Ritalin) or benzodiazepine (e.g. Ativan, Xanax) and seeking to continue it?

Are you currently prescribed a stimulant (e.g. Adderall, Ritalin) or benzodiazepine (e.g. Ativan, Xanax) and seeking to continue it?

Are you currently prescribed a stimulant (e.g. Adderall, Ritalin) or benzodiazepine (e.g. Ativan, Xanax) and seeking to continue it?

Are you currently prescribed a stimulant (e.g. Adderall, Ritalin) or benzodiazepine (e.g. Ativan, Xanax) and seeking to continue it?

We prescribe controlled substance medications (i.e. stimulants, benzodiazepines) only to patients in OR, WA and UT with a required minimum once yearly in-office visit in Clackamas OR, Issaquah WA, Lehi UT, or Layton UT when clinically appropriate (please view our stimulant policy). It may be helpful to note that in our practice, we rarely use benzodiazepines (e.g. Xanax, Ativan, Klonopin). Contact admin@skycloudhealth.com with questions.

See Resources

In-office visits are required once a year in Clackamas OR, Issaquah WA, Lehi UT, or Layton UT for patients who are prescribed controlled substances. Click “Okay” to continue.

We prescribe controlled substance medications (i.e. stimulants, benzodiazepines) only to patients in OR, WA and UT with a required minimum once yearly in-office visit in Clackamas OR, Issaquah WA, Lehi UT, or Layton UT when clinically appropriate (please view our stimulant policy). It may be helpful to note that in our practice, we rarely use benzodiazepines (e.g. Xanax, Ativan, Klonopin). Contact admin@skycloudhealth.com with questions.

See Resources

In-office visits are required once a year in Clackamas OR, Issaquah WA, Lehi UT, or Layton UT for patients who are prescribed controlled substances. Click “Okay” to continue.

 

 

We do not prescribe stimulant, benzodiazepines, Suboxone, or other controlled substances in Minnesota. If you would still like to schedule, click Okay. To see other Resources, click “Resources.”

Resources

Which insurance plan do you have?

Which insurance plan do you have?

Which insurance plan do you have?

Which insurance plan do you have?

Which insurance plan do you have?

Which insurance plan do you have?

If your insurance was not listed, we may not be in your network. Please email billing@skycloudhealth.com to verify.

See Resources

If your insurance was not listed, we may not be in your network. Please email billing@skycloudhealth.com to verify.

See Resources

How old are you?

We do not have providers serving people under 18 at this time who accept your insurance. Email us for temporary self-pay options while our pediatric providers are in the credentialing process. Here is a list of resources.

Due to federal laws that prevent us from seeing patients who are qualified for Medicare as self-pay patients without opting out of Medicare, we are unable to see patients who are over 65 at this time. Here is a list of resources.

How old are you?

We do not have providers serving people under the age of 13 at this time. Here is a list of resources.

Due to federal laws that prevent us from seeing patients who are qualified for Medicare as self-pay patients without opting out of Medicare, we are unable to see patients who are over 65 at this time. Here is a list of resources.

How old are you?

We do not have providers serving people under the age of 13 at this time. Here is a list of resources.

Due to federal laws that prevent us from seeing patients who are qualified for Medicare as self-pay patients without opting out of Medicare, we are unable to see patients who are over 65 at this time. Here is a list of resources.

How old are you?

We do not have providers serving people under the age of 13 at this time. Here is a list of resources.

Due to federal laws that prevent us from seeing patients who are qualified for Medicare as self-pay patients without opting out of Medicare, we are unable to see patients who are over 65 at this time. Here is a list of resources.

Our provider is in process of panelling with your insurance. You can see him at a discounted self pay rate until he is contracted. Click below to schedule.

Resources

Registration forms must be completed within 24 hours of booking or appointment will be cancelled. Forms take 15-20 minutes to complete. Please have your payment method, state ID and insurance card available.

Schedule Appointment

Registration forms must be completed within 24 hours of booking or appointment will be cancelled. Forms take 15-20 minutes to complete. Please have your payment method, state ID and insurance card available.

Schedule Now

Dose/Med

Our providers will review your submission to determine if we are a good fit for your needs. Please submit the following required information for the potential patient (yourself or your child): insurance, age, current medications names and dosages. If the potential patient is taking a benzodiazepine, specify if they are looking to taper off of the medication. If the potential patient is a minor, please specify whether or not they have a history of self-harm. *It may be helpful to note that in our practice, we rarely use benzodiazepines (e.g., Ativan, Xanax, Klonopin).

Name(Required)
Name(Required)

Med/Dose

Our providers will review your submission to determine if we are a good fit for your needs. Please submit the following required information for the potential patient (yourself or your child): insurance, age, current medications names and dosages. If the potential patient is taking a benzodiazepine, specify if they are looking to taper off of the medication. If the potential patient is a minor, please specify whether or not they have a history of self-harm. *It may be helpful to note that in our practice, we rarely use benzodiazepines (e.g., Ativan, Xanax, Klonopin).

Name(Required)
Name(Required)

Are you currently prescribed a stimulant (e.g. Adderall, Ritalin) or benzodiazepine (e.g. Ativan, Xanax) and seeking to continue it?

We do not prescribe stimulant, benzodiazepines, Suboxone, or other controlled substances in Arizona. If you would still like to schedule, click Okay. To see other Resources, click “Resources.”

Resources

Which insurance plan do you have?

If your insurance was not listed, we may not be in your network. Please email billing@skycloudhealth.com to verify.

See Resources

We are accepting self-pay patients for psychotherapy in Oregon and Utah. Our provider is in process of credentialing with several insurances. We have a waitlist for clients in Washington.

 

Resources

Psychotherapy Consultation (OR and UT)

We are accepting PacificSource, Aetna and self-pay patients for psychotherapy in Oregon and Utah. Our provider, Nat Day LCSW, is also in process of credentialing with other insurance panels - Cigna, BCBS, and Moda. Please provide your contact information for a 15 minute free consultation phone call.

Name(Required)

Psychotherapy Waitlist

Our psychotherapy waitlist is open for patients located in Oregon, Washington, and Utah with Cigna, Aetna, PacificSource, United, Moda, and self-pay pay sources only. The waitlist is currently closed for Regence (BCBS) and Providence insurance. Our psychotherapy providers treat ages 18-64. This waitlist is currently 6-12 months out, depending on age, state and insurance. Please provide the information requested below. Note: do not use this form in an emergency.

Name(Required)
Name(Required)

Para agendar una cita, favor contactarnos al (503) 694-3381.

Proceed with online registration or by phone?

Phone Number: (503) 694-3381

Phone Hours: 3:00pm-6:30pm (PT) TWTh / 11am-2pm (PT) Sat and Sun

Phone Registration

Register below for a phone call, or call our office number (503) 694-3381 ext. 2 to register. Please only request for a phone call for yourself.

Must be a legal guardian of the potential patient.

Thanks for submitting this form! We will contact you during the specified times.

How old are you?

We do not have providers serving people under the age of 18 at this time. Here is a list of resources.

Due to federal laws that prevent us from seeing patients who are qualified for Medicare as self-pay patients without opting out of Medicare, we are unable to see patients who are over 65 at this time. Here is a list of resources.

Registration forms must be completed within 24 hours of booking or appointment will be cancelled. Forms take 15-20 minutes to complete. Please have your payment method, state ID and insurance card available.

Schedule Now

How old are you?

We do not have providers serving people under the age of 13 at this time. Here is a list of resources.

Registration forms must be completed within 24 hours of booking or appointment will be cancelled. Forms take 15-20 minutes to complete. Please have your payment method, state ID and insurance card available.

Schedule Appointment

Are you currently prescribed a stimulant (e.g. Adderall, Ritalin) or benzodiazepine (e.g. Ativan, Xanax) and seeking to continue it?

We prescribe controlled substance medications (i.e. stimulants, benzodiazepines) only to patients in OR, WA , UT, and NM with a required minimum once yearly in-office visit in Clackamas OR, Issaquah WA, Lehi UT, Layton UT, Albuquerque NM when clinically appropriate (please view our stimulant policy). It may be helpful to note that in our practice, we rarely use benzodiazepines (e.g. Xanax, Ativan, Klonopin). Contact admin@skycloudhealth.com with questions.

Resources

Which insurance plan do you have?

If your insurance was not listed, we may not be in your network. Please email billing@skycloudhealth.com to verify.

See Resources

How old are you?

We do not have providers serving people under the age of 13 in New Mexico at this time. Here is a list of resources.

Due to federal laws that prevent us from seeing patients who are qualified for Medicare as self-pay patients without opting out of Medicare, we are unable to see patients who are over 65 at this time. Here is a list of resources.

Registration forms must be completed within 24 hours of booking or appointment will be cancelled. Forms take 15-20 minutes to complete. Please have your payment method, state ID and insurance card available.

Schedule Appointment

How old are you?

We do not have providers serving people under the age of 17 at this time who take your insurance. Here is a list of resources.

Due to federal laws that prevent us from seeing patients who are qualified for Medicare as self-pay patients without opting out of Medicare, we are unable to see patients who are over 65 at this time. Here is a list of resources.

How old are you?

We do not have providers serving people under the age of 13 at this time. Here is a list of resources.

Due to federal laws that prevent us from seeing patients who are qualified for Medicare as self-pay patients without opting out of Medicare, we are unable to see patients who are over 65 at this time. Here is a list of resources.

How old are you?

We do not have providers serving people under the age of 13 at this time. Here is a list of resources.

Due to federal laws that prevent us from seeing patients who are qualified for Medicare as self-pay patients without opting out of Medicare, we are unable to see patients who are over 65 at this time. Here is a list of resources.

How old are you?

We do not have providers serving people under the age of 13 at this time. Here is a list of resources.

Due to federal laws that prevent us from seeing patients who are qualified for Medicare as self-pay patients without opting out of Medicare, we are unable to see patients who are over 65 at this time. Here is a list of resources.

Registration forms must be completed within 24 hours of booking or appointment will be cancelled. Forms take 15-20 minutes to complete. Please have your payment method, state ID and insurance card available.

Schedule Now

Registration forms must be completed within 24 hours of booking or appointment will be cancelled. Forms take 15-20 minutes to complete. Please have your payment method, state ID and insurance card available.

 

Schedule Appointment

Registration forms must be completed within 24 hours of booking or appointment will be cancelled. Forms take 15-20 minutes to complete. Please have your payment method, state ID and insurance card available.

Schedule Appointment

Registration forms must be completed within 24 hours of booking or appointment will be cancelled. Forms take 15-20 minutes to complete. Please have your payment method, state ID and insurance card available.

*All times are in Pacific Standard Time (PST).

Schedule Appointment

Registration forms must be completed within 24 hours of booking or appointment will be cancelled. Forms take 15-20 minutes to complete. Please have your payment method, state ID and insurance card available.

*All times are in Pacific Standard Time (PST).

Schedule Appointment

Registration forms must be completed within 24 hours of booking or appointment will be cancelled. Forms take 15-20 minutes to complete. Please have your payment method, state ID and insurance card available.

Schedule Appointment

We prescribe controlled substance medications (i.e. stimulants, benzodiazepines) only to patients in OR, WA , UT, and NM with a required minimum once yearly in-office visit in Clackamas OR, Issaquah WA, Lehi UT, Layton UT, Albuquerque NM when clinically appropriate (please view our stimulant policy). It may be helpful to note that in our practice, we rarely use benzodiazepines (e.g. Xanax, Ativan, Klonopin). Contact admin@skycloudhealth.com with questions.

See Resources

In-office visits are required once a year in Clackamas OR, Issaquah WA, Lehi UT, or Layton UT for patients who are prescribed controlled substances. Click “Okay” to continue.

Which insurance plan do you have?

How old are you?

We do not have providers serving people under the age of 13 at this time. Here is a list of resources.

Due to federal laws that prevent us from seeing patients who are qualified for Medicare as self-pay patients without opting out of Medicare, we are unable to see patients who are over 65 at this time. Here is a list of resources.

Registration forms must be completed within 24 hours of booking or appointment will be cancelled. Forms take 15-20 minutes to complete. Please have your payment method, state ID and insurance card available.

Schedule Appointment

Dose/Med (UT)

Our providers will review your submission to determine if we are a good fit for your needs. Please submit the following required information for the potential patient (yourself or your child): insurance, age, current medications names and dosages. If the potential patient is taking a benzodiazepine, specify if they are looking to taper off of the medication. If the potential patient is a minor, please specify whether or not they have a history of self-harm. *It may be helpful to note that in our practice, we rarely use benzodiazepines (e.g., Ativan, Xanax, Klonopin).

Name(Required)
Name(Required)

How old are you?

We do not have providers serving people under 18 at this time who accept your insurance. Email us for temporary self-pay options while our pediatric providers are in the credentialing process. Here is a list of resources.

Due to federal laws that prevent us from seeing patients who are qualified for Medicare as self-pay patients without opting out of Medicare, we are unable to see patients who are over 65 at this time. Here is a list of resources.

How old are you?

We do not have providers serving people under the age of 13 at this time. Here is a list of resources.

Due to federal laws that prevent us from seeing patients who are qualified for Medicare as self-pay patients without opting out of Medicare, we are unable to see patients who are over 65 at this time. Here is a list of resources.

How old are you?

We do not have providers serving people under the age of 13 at this time. Here is a list of resources.

Due to federal laws that prevent us from seeing patients who are qualified for Medicare as self-pay patients without opting out of Medicare, we are unable to see patients who are over 65 at this time. Here is a list of resources.

How old are you?

We do not have providers serving people under the age of 13 at this time. Here is a list of resources.

Due to federal laws that prevent us from seeing patients who are qualified for Medicare as self-pay patients without opting out of Medicare, we are unable to see patients who are over 65 at this time. Here is a list of resources.

Registration forms must be completed within 24 hours of booking or appointment will be cancelled. Forms take 15-20 minutes to complete. Please have your payment method, state ID and insurance card available.

*All times are in Pacific Standard Time (PST).

Schedule Appointment

Registration forms must be completed within 24 hours of booking or appointment will be cancelled. Forms take 15-20 minutes to complete. Please have your payment method, state ID and insurance card available.

Schedule Now

Registration forms must be completed within 24 hours of booking or appointment will be cancelled. Forms take 15-20 minutes to complete. Please have your payment method, state ID and insurance card available.

Schedule Appointment

Registration forms must be completed within 24 hours of booking or appointment will be cancelled. Forms take 15-20 minutes to complete. Please have your payment method, state ID and insurance card available.

Schedule Appointment

How old are you?

We do not have providers serving people under the age of 13 at this time. Here is a list of resources.

Due to federal laws that prevent us from seeing patients who are qualified for Medicare as self-pay patients without opting out of Medicare, we are unable to see patients who are over 65 at this time. Here is a list of resources.

How old are you?

We do not have providers serving people under the age of 13 at this time. Here is a list of resources.

Registration forms must be completed within 24 hours of booking or appointment will be cancelled. Forms take 15-20 minutes to complete. Please have your payment method, state ID and insurance card available.

Schedule Appointment

Registration forms must be completed within 24 hours of booking or appointment will be cancelled. Forms take 15-20 minutes to complete. Please have your payment method, state ID and insurance card available.

*All times are in Pacific Standard Time (PST).

Schedule Appointment

Registration forms must be completed within 24 hours of booking or appointment will be cancelled. Forms take 15-20 minutes to complete. Please have your payment method, state ID and insurance card available.

Schedule Telehealth AppointmentSchedule In-Person Appointment

Registration forms must be completed within 24 hours of booking or appointment will be cancelled. Forms take 15-20 minutes to complete. Please have your payment method, state ID and insurance card available.

Schedule Telehealth AppointmentSchedule In-Person Appointment

Registration forms must be completed within 24 hours of booking or appointment will be cancelled. Forms take 15-20 minutes to complete. Please have your payment method, state ID and insurance card available.

Schedule Telehealth AppointmentSchedule In-Person Appointment

Which insurance plan do you have?

Are you currently prescribed a stimulant (e.g. Adderall, Ritalin) or benzodiazepine (e.g. Ativan, Xanax) and seeking to continue it?

We do not prescribe stimulant, benzodiazepines, Suboxone, or other controlled substances in Nevada. If you would still like to schedule, click Okay. To see other Resources, click “Resources.”

Resources

If your insurance was not listed, we may not be in your network. Please email billing@skycloudhealth.com to verify.

See Resources

How old are you?

We do not have providers serving people under the age of 13 at this time. Here is a list of resources.

In-office visits are required once a year in Clackamas OR, Issaquah WA, Lehi UT, Layton UT, or Albuquerque NM for patients who are prescribed controlled substances. Click “Okay” to continue.

Which insurance plan do you have?

Dose/Med (NM)

Our providers will review your submission to determine if we are a good fit for your needs. Please submit the following required information for the potential patient (yourself or your child): insurance, age, current medications names and dosages. If the potential patient is taking a benzodiazepine, specify if they are looking to taper off of the medication. If the potential patient is a minor, please specify whether or not they have a history of self-harm. *It may be helpful to note that in our practice, we rarely use benzodiazepines (e.g., Ativan, Xanax, Klonopin).

Name(Required)
Name(Required)

Registration forms must be completed within 24 hours of booking or appointment will be cancelled. Forms take 15-20 minutes to complete. Please have your payment method, state ID and insurance card available.

Schedule Appointment

How old are you?

We do not have providers serving people under the age of 13 at this time. Here is a list of resources.

Due to federal laws that prevent us from seeing patients who are qualified for Medicare as self-pay patients without opting out of Medicare, we are unable to see patients who are over 65 at this time. Here is a list of resources.

How old are you?

We do not have providers serving people under the age of 13 at this time. Here is a list of resources.

Registration forms must be completed within 24 hours of booking or appointment will be cancelled. Forms take 15-20 minutes to complete. Please have your payment method, state ID and insurance card available.

 

Schedule Appointment

Registration forms must be completed within 24 hours of booking or appointment will be cancelled. Forms take 15-20 minutes to complete. Please have your payment method, state ID and insurance card available.

Schedule Appointment

How old are you?

We do not have providers serving people under the age of 13 at this time. Here is a list of resources.

How old are you?

We do not have providers serving people under the age of 13 at this time. Here is a list of resources.

We’re sorry, we only able to take patients with this insurance Here is a list of resources.

How old are you?

We do not have providers serving people under the age of 13 at this time. Here is a list of resources.

How old are you?

We do not have providers serving people under the age of 13 in New Mexico at this time. Here is a list of resources.

Due to federal laws that prevent us from seeing patients who are qualified for Medicare as self-pay patients without opting out of Medicare, we are unable to see patients who are over 65 at this time. Here is a list of resources.

How old are you?

We do not have providers serving people under the age of 17 at this time who take your insurance. Here is a list of resources.

Due to federal laws that prevent us from seeing patients who are qualified for Medicare as self-pay patients without opting out of Medicare, we are unable to see patients who are over 65 at this time. Here is a list of resources.

Registration forms must be completed within 24 hours of booking or appointment will be cancelled. Forms take 15-20 minutes to complete. Please have your payment method, state ID and insurance card available.

Schedule Appointment

Registration forms must be completed within 24 hours of booking or appointment will be cancelled. Forms take 15-20 minutes to complete. Please have your payment method, state ID and insurance card available.

 

Schedule Appointment

How old are you?

We do not have providers serving people under the age of 13 at this time. Here is a list of resources.

Due to federal laws that prevent us from seeing patients who are qualified for Medicare as self-pay patients without opting out of Medicare, we are unable to see patients who are over 65 at this time. Here is a list of resources.

Registration forms must be completed within 24 hours of booking or appointment will be cancelled. Forms take 15-20 minutes to complete. Please have your payment method, state ID and insurance card available.

Schedule Now

Your information is kept confidential and helps us ensure we can provide you with care. Assistance: 503-694-3381 | admin@skycloudhealth.com

If you are in a mental health crisis, do not use this form, call 988.