Self-Scheduling

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To get started:

Please answer the following questions to schedule your first appointment. This should take no more than 5 minutes.

All the following questions pertain to the patient's information.

Please have your insurance card available to complete the scheduling process. If you do not have insurance and would like to learn about other options, please call us at 877-759-5017.

Some things to note:

Your first appointment will be held virtually.

All information is held in the strictest confidence. At no point is information disclosed or shared without a community member's written consent.
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Are you currently or have you ever been an Eleanor Health member?* This field is required.
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Are you 18 or older?* This field is required.
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To get started, let's make sure we provide services in your state. Where do you live?* This field is required.
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Do you currently have medical insurance?* This field is required.
YESNO
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Who is your current insurance provider?* This field is required.Choose from this list of insurance providers in Massachusetts
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MBHP_ Community Care Cooperative (C3)
MBHP_Masshealth PCC Plan
MBHP_Revere Health Choice (Formerly Steward Health Choice)
MBHP_Partners Healthcare Choice
United Healthcare HMO
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United Healthcare POS
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Aetna HMO
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Out of State BCBS Plan (BlueCard Members Only)
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Are you 21 or older?* This field is required.
YESNO
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Thank you for considering Eleanor Health. We are committed to supporting you on your journey. You must be 21 years or older to receive care from Eleanor Health if you have MBHP as your insurance.

While you may not be eligible for our services at this time, we’re here to help you find the support you need. Here are some additional resources that are available to you:

SAMHSA’s National Helpline: Call 1-800-662-HELP (4357)

Suicide & Crisis Lifeline: Call 988 or 800-273-8255
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Who is your current insurance provider?* This field is required.Choose from this list of insurance providers in Louisiana
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Aetna HMO
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Aetna PPO
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United Healthcare Dual Complete
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United Healthcare POS
United Healthcare PPO
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Who is your current insurance provider?* This field is required.Choose from this list of insurance providers in New Jersey
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Aetna HMO
Aetna POS
Aetna PPO
Horizon BCBS NJ Federal Plan
Horizon BCBS NJ HMO
Horizon BCBS NJ Medicare Advantage
Horizon BCBS NJ POS
Horizon BCBS NJ PPO
Horizon NJ Health
Oscar Health (Optum/UBH Behavioral Health Coverage Only)
United Healthcare HMO
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United Healthcare PPO
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Who is your current insurance provider?* This field is required.Choose from this list of insurance providers in North Carolina
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Aetna HMO
Aetna POS
Aetna PPO
Amerihealth Caritas NC
BCBS NC Federal Plan
BCBS NC HMO
BCBS NC Medicare Advantage
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BCBS NC PPO
Carolina Complete Health
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Who is your current insurance provider?* This field is required.Choose from this list of insurance providers in Ohio
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Aetna HMO
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Anthem_BCBS OH HMO
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Medical Mutual of Ohio
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Who is your current insurance provider?* This field is required.Choose from this list of insurance providers in Washington
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Aetna HMO
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Regence_BCBS WA HMO
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Regence_BCBS WA PPO
United Healthcare HMO
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United Healthcare PPO
WellPoint WA
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Who is your current insurance provider?* This field is required.Choose from this list of insurance providers in Texas
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AARP Medicare Replacement
Aetna HMO
Aetna POS
Aetna PPO
United Healthcare Dual Complete
United Healthcare HMO
United Healthcare POS
United Healthcare PPO
Not Sure/Other
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Who is your current insurance provider?* This field is required.Choose from this list of insurance providers in Florida
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Please Select
Aetna HMO
Aetna PPO
Aetna POS
United Healthcare HMO
United Healthcare PPO
United Healthcare POS
Not Sure/Other
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Full Name* This field is required.
First Name
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Date of Birth* This field is required.
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Thank you for considering Eleanor Health. We are committed to supporting you on your journey. If you don't see your insurance listed, we may still be able to help. To verify if Eleanor Health is in-network with your insurance plan, or to see if you qualify for our self-pay program, fill out this form and someone from our team will reach out to you or give us a call at 877-759-5017.
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Thank you for considering Eleanor Health. We are committed to supporting you on your journey. We now offer self-pay options to those who qualify. For more information on our self-pay program, please visit our self-pay page or call us at 877-759-5017 to chat with our team.
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Thank you for considering Eleanor Health. We are committed to supporting you on your journey. Unfortunately we do not currently serve members in your location. If you would like to be notified once we start serving members in your area, please fill out this form and we will reach out to you when treatment is available.

While you may not be eligible for our services at this time, we’re here to help you find the support you need. Here are some additional resources that are available to you:

SAMHSA’s National Helpline: Call 1-800-662-HELP (4357)

Suicide & Crisis Lifeline: Call 988 or 800-273-8255
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Thank you for considering Eleanor Health. We are committed to supporting you on your journey. You must be 18 years or older to receive care from Eleanor Health.

While you may not be eligible for our services at this time, we’re here to help you find the support you need. Here are some additional resources that are available to you:

SAMHSA’s National Helpline: Call 1-800-662-HELP (4357)

Suicide & Crisis Lifeline: Call 988 or 800-273-8255
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We’re sorry, we are unable to schedule current Eleanor Health community members online at this time. Please reach out to us at 1-877-759-5017 to schedule an appointment.
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By clicking "submit" you confirm this information is accurate and you will be redirected to start scheduling your first appointment.

If you have any questions, please call (877) 759-5017 and our team will be standing by to assist you.
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