If you will be using insurance benefits, you will need to call your insurance company prior to your first session. Following are some guidelines and questions to help you when you call them. If you have any questions
or problems obtaining this information from your insurance company , please give us a call at 206-781-3593.
Provider: Jan Canniff LMHC NCC
Washington State License #1550
Tax ID #91-1821193
1. Benefits:
A) Deductible _________________ Amount Met this Year ____________
B) Amount your plan will cover? $___________________ or percentage _________
C) Yearly Maximum $_____________
D)Effective Date _____________ 
2. Services Covered: (Yes or No)
~~Individual ________ ~~Couple_________ ~~Family________Premarital_______
3. Is written referral or precertification needed for visits? _________________
4. Name of person you spoke with___________________________________ Date_____________
Questions for your Insurance Company
Specializing in Individual & Couples Counseling
