Level of Seriousness
TYFC CARES HTT, before I connect you with a 24 hr. Life Specialist, may I first take down your full name, mobile number and email address?
[Blind transfer to 407-545-5257]
Not a problem, Do you mind if I put you on a brief hold while I transfer your call?
What is your first name?
What is your last name?
What is your email address?
Do you have a mobile phone that can receive texts?
Alternate Phone Number
Do you have an alternative phone number?
What city are you from?
Purpose of Call
Need a Psychiatrist
Contact Office Administration
Are you calling about residential treatment?
Please give me a moment, while I look up our company directory so that I can transfer you to someone that can better help you?
Relationship to Patient
Family- Biological Parent
Family- Step Parent
Family- Other Relative
Are you calling for yourself or someone else? [IF not 'Self' THEN] What is your relationship to the patient?
May I ask you some personal questions to determine how you will pay for treatment?
Ins. Medicaid, Medi-Cal, Tri-Care, or any Military/Govt.
Which of the following would be your primary source of payment...?
Verification of Benefits
Send the form via Email
Would you like me to take down your insurance policy information so we can verify your out-of-network benefits? I can also email you the form, if you don't the info handy.
Please hold while I lookup the phone numbers and websites of lenders we work with. I'll also email and text you the information as well. You'll be able to apply online or call for instant qualification.
Middle to Upper
Would Rather Not Say
In order to serve you better we will need to know your income bracket? Is it None, Lower, Middle, or Middle-to-Upper?
Would you like to apply for unsecured loan financing?
Alternative Funding Source
Do you have an alternative source of funding such as...?
Social Media Site
TV, Radio, Print
Name of Agency
Name of the Person
Name of Social Media Site
Name of TV, Radio, Print
Search Engine Keywords