Patient Forms

Call High Plains Mental Health Center at (785) 628-2871 or (800) 432-0333. We will take your information and help you schedule your intake assessment with a mental health professional. Typically, intake appointments are available the same day or next day. Services are available in-person or via telehealth from the comfort of your home.

We understand anyone can experience mental health challenges at some point during their lives, and we will address your concerns without judgment—as the real health concerns they are. We will connect you with a therapist to get started, and you can expect an intake assessment. At your first appointment, our staff will work with you on reaching a diagnosis and setting recovery goals. We will then recommend a treatment plan and help you schedule future appointments as needed. Entry paperwork is required for new individuals receiving services, including questions about the symptoms that are bothering you and family medical history. Individuals are encouraged to come to their first appointment 30 minutes early for paperwork. You can find and submit intake paperwork online from our website.

Please bring your health insurance card and the cost of any copays. If your insurance is provided through a family member, please have their date of birth available. Otherwise, we might not be able to access your health insurance policy.

During registration, you will be asked to provide information about insurance and income in order to determine your payment rate. Fees vary according to the services provided and are comparable to or lower than the cost of similar services in private agencies. High Plains is an approved provider for mental health services for many insurance providers. Our staff files claims to private insurers, Medicaid (KanCare) and Medicare. Individuals without insurance may qualify for sliding scale fees. Payment is expected at the time service is provided. Services are not denied based on ability to pay. Individuals living outside the 20-county catchment assigned to High Plains Mental Health Center may seek treatment here but will not be eligible for reduced fees.

Maintaining confidentiality is essential. Information you share with members of our staff will not be given to any other person without your written consent, or in special situations defined by law. We encourage individuals receiving services to consider signing Release Of Information forms if needed so your provider can communicate with others involved in treatment, such as a primary care physician or school counselor. We cannot share information with other providers without your written permission.