Office
3 Woodridge Road
Wayland, MA 01778
Tel: 617.492.9224
Fax: 508.358.1199
Information for Clients
Documents for Your First Appointment
Save time on the day of your appointment by downloading the 5 pre-appointment documents you'll need to complete and sign.
Intake Information:
1. New Patient Intake Form
2. New Patient Medical History Checklist
HIPAA Privacy Policies and Treatment & Fee Agreements:
3. HIPAA Privacy Disclosure
4. HIPAA Privacy Disclosure Acknowledgement
5. Treatment and Fee Agreement
Accepted Health Insurance Plans
As a licensed psychologist, Dr. Davis is eligible for reimbursement from all indemnity insurance plans and the following managed care plans from Blue Cross and Blue Shield:
| Blue Care Elect (PPO/EPO) | Blue Precision/PPO Blue Options v.3 | Medicare HMO Blue |
| Medicare PPO Blue | Personal Help Connection | PPO Blue Options v.2 |
| Preferred Blue PPO | Preferred Blue PPO Options v.2 | Preferred Blue PPO Options v.3 |
In any case, please call the 1-800 number on your card and confirm that they will provide coverage for services if you intend to use your insurance. If your plan allows for out of network coverage, Dr. Davis can provide the billing paperwork required for you to seek reimbursement directly from your insurance company.
Getting Mental Health Coverage for Out of Network Providers
The Massachusetts Psychological Association provides this helpful infomation about obtaining out-of-network mental health care.
Career Self-assessment Testing
If you are a Career Counseling client of Dr. Davis, please use the links below to the online tools included with your career counseling services. Instructions and passwords will be emailed to you as soon as your payment is received.
Please also download and complete the Personal Summary (below). You may print and complete by hand, or type your answers directly into the PDF form before printing. Please note, however, that PDF format does not allow you to save an electronic copy of your work.