Plan Ahead Before You Call Employee Assistance Benefits

Outpatient Mental Health

You may find the following form useful when talking to your insurance provider.

First download this PDF form  ,print it and fill it out while talking to your insurance provider. (left click to download the form, choose "save", save it to someplace that you can find it… desktop perhaps). In either case, please bring the completed form with you to your first visit.

Fill out the top portion in BEFORE you call your insurance company:

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New Client Interview

ONLY required once. New Clients are encouraged to Pre-Pay for their first interview session to protect their time slot.

Download files needed Registration Packet  

Appointments scheduled for you are set aside expressly for you, therefore any not kept will be billed unless canceled 48 hours in advance.

Dr. Ray Smith


Ray Wm. Smith, Ed.D
9507 N Division Street Suite A
Spokane, WA 99218-1556

Phone: (509) 466-6632
Fax: (509) 466-0117
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Office Hours:
Monday - Friday, 8 a.m. - 8 p.m.
Saturday Mornings