https://www.mass.gov/doc/fillable-section-12-form/download
https://www.mass.gov/doc/fillable-section-12-form/download

"If you plan on being anything less than you are capable of being, you will probably be unhappy all the days of your life."

 Abraham Maslow


New/Existing Patient 
Information & Forms

__________________________

NO WAITING LIST


If you or anyone you know needs mental health treatment, please complete the secure forms below and they will be transferred directly to our secure electronic platform. A clinician will review the services you are inquiring about and get back to you to set up an appointment if we are able to meet the individual treatment you deserved. Thank you for making Beautiful Mind PMHS your mental health services of choice. It is and always will be an honor to serve you and thank you for the trust you have in us.


Please note: New patient initial visit must be scheduled by staff after sending us the completed forms.


Legal Forms for Acute Mental Health Care Treatment


Existing patients may request a follow-up visit from the two main providers below or through the patient fusion portal.

Existing Patient Portal Dr. J's Scheduling Site Mrs. Sherley Boisvert's Scheduling Site

Outside hospitals planning the discharge of a current patient may also look for availability below. If none is available and the patient needs a follow up sooner than a month, please call: 781-964-1266


Please Fax discharge summary to 781-558-9207.

Mental Health Patient — Randolph, MA — Beautiful Mind Psychiatric Mental Health Services, LLC

Billing
& Payment


BMPMHS practice participates with many, but not all insurance plans. It is your responsibility to contact your insurance company to verify that we participate with your plan and the provider you will be seeing is in network with them. It is also your responsibility to provide accurate insurance information prior to the service. If you do not have your up-to-date insurance information, we will reschedule your appointment or classify your appointment as self-pay. Telehealth services may not be covered by all insurance plans. If your insurance does not cover the Telehealth visit, you will be considered self-pay and our published self-pay fee will apply. Non-covered Telehealth visits will be the patient’s responsibility.


Average Cost Per Session: $100 - $300

​No Call / No Show Fee: $100

Accepted
Payment Methods


Co-pay, deductible amounts, or private pay is due on the day of your visit.​

American Express

Cash

Cash APP ($DrJeanniton)

Check

Discover

Health Savings Account

​Paypal (paypal.me/beautifulmindpmhs)

Mastercard

​Venmo (@DrMJeanniton)

VISA

Accepted
Insurance Plans


Aetna

AllWays Health Partners

Anthem

BCBS / Blue Cross and Blue Shield

BMC HealthNet

Beacon

Cigna

Emblem Health

Fallon Health

Group Insurance Commission

Harvard Pilgram

MPHP / MassHealth

MVP Health Care

Medicaid

Medicare

New York State Health Insurance Plan

Optum

Oxford

Private Pay

TRICARE

Tufts

Tufts PRIVATE / Premium

UHC - United Healthcare

UBH - United Behavioral Health

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