Patient Forms

Who can be assessed?

Testing is offered for those over the age of 5, although it is often advantageous to wait (if possible) until age 7. This allows us to use a wider variety of assessments.
Do I need a referral?

Heartland does not require a referral for testing services.
Where do you offer testing?

Testing is offered in our Pella office only. The Pella office is located at 2611 Washington St, Pella, IA 50219.
What does testing cost?

Everyone's insurance plan is different, and the out-of-pocket cost will vary based on your coverage. The Insurance Worksheet for Psychological Testing walks you through the process of contacting your insurance to determine what your out-of-pocket cost will be. Rates for testing vary based on age and specific tests used.
Rate Estimates (before insurance):

Under 18: $1,800 18 and Over: $2,145
I have Medicaid. Can I be tested?

While we can accept Medicaid for therapy services, at this time we cannot submit to Medicaid for testing. You may still be tested but will be responsible for covering the full out-of-pocket cost at the time of service. See rates above.
What if I have non-Medicaid primary insurance, but I have Medicaid as a secondary insurance?

As long as the primary insurance is one that our psychologists are credentialed with, we can submit testing claims to your primary insurance. We still cannot submit to Medicaid, so you will be responsible for any amount your primary insurance does not cover.
Are there any resources that can help me cover the cost of testing?

Heartland is now accepting Care Credit as a payment option, which can offer the opportunity for repayment over time. Click HERE to learn more.

Before scheduling your first appointment, you will need to call the office, register as a new patient, and complete new patient forms.

Click on the tab below that best describes the service you need to schedule for and complete all the forms in your dropdown menu. If you are not able to complete online forms, we are happy to provide alternative options; call the office for more information.

Please note that after you have submitted your paperwork, the office needs 24 hours to receive and process it. Once we have had sufficient time, you can call the office to schedule your first appointment.