top of page

Please complete the appropriate intake packet and return it with a copy of your insurance card. Email the completed packet to ccockayne@caciowa.com or fax to 515-255-2228. Once the packet and insurance card are received, we will call you to schedule an appointment. Thank you.

New Patient Packet:
Child/Adolescent

Release of Information Form

New Patient Packet:
Adult Over 18

Good Faith Estimate Form

New Couples
Counseling Packet

Telehealth Consent

© 2025 by Counseling Associates of Central Iowa, PC

3737 Woodland Ave.

Suite 601

West Des Moines, IA 50266

515-255-2224

​

Privacy Policy

bottom of page