SESSION INQUIRY

Name *

First Name

Last Name

Type of Therapy *

Check all that apply.

Individual

Couple

Family

Availability *

Check all that apply.

Weekday Mornings

Weekday Afternoons

Weekday Evenings

Location Preference *

Check all that apply.

Office

Video

Insurance *

We do not accept HMOs, Medicare, Medicaid or Community Plans. Please confirm with your insurance plan if we are in-network. Please note - Not all therapists are in-network with each insurance company.

BCBS PPO

BCBS Anthem

Optum/United Healthcare

Aetna

Cigna

TrustMark/Allied/Meritain

None