Home
About
Fees
Contact
Request an Appointment
Let's Get Started!
If you are currently having thoughts of harming yourself or others, please immediately dial 911 or the National Suicide Lifeline at 800-273-8255 or go to the nearest emergency room.
If you wish to expedite the insurance verification process for a sooner appointment, please provide your information below. Your insurance benefits must be confirmed before an appointment is scheduled. If you are self-pay, please put "N/A" in the insurance related text boxes to the submit form. Please note: my contracting with Aetna and Cigna is
estimated
to be completed by March 1, 2021.
*
Indicates required field
Name
*
First
Last
Email
*
Phone Number
*
Is it ok to leave a detailed message?
*
Date of Birth?
*
Dr. Muir is board certified to treat adults 18 & up at this time.
Insurance or Self-Pay?
*
please choose one
Aetna (tent. by March 1, 2021)
Cigna (tent. by March 1, 2021)
United Behavioral Health
United Healthcare (Note: GEHA is out of network)
Self-Pay/Out-of-Network
Insurance Patient ID# and Group#
*
Please list the "Provider Services" or "Claims" number on back of your card
*
This is usually an 800, 866 number.
Brief Reason for the Appointment
*
When Did your symptoms start?
*
If you have struggled with psychiatric symptoms your whole life, when did your symptoms worsen or recur to prompt you to seek treatment now?
Submit
Home
About
Fees
Contact
Request an Appointment