Form Form

New Client Application Form

Please fill out this form completely. 

Yvonne Sinclair LMFT is not accepting any court ordered or court related clients.

If a court report or court appearance may be requested, please let me help you find a different therapist. 

Yuba City Office

Accepting Anthem, United Behavioral Health, and Optum Insurance

Client's Name

If client is a minor please state their age.

Insured's name

Insurance ID number

Name of Insurance

Claims address

Claims address For Optum, UBH, and Anthem clients-

Authorization number

For Optum, UBH, and Anthem clients

Your best contact email address

Your best contact Phone Number

Issues to be addressed

Best time of day for appointment-

Yvonne Sinclair LMFT-Yuba City Office hours on Tuesday, Wednesday, and Thursday

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