SESSION INQUIRY

Name *

First Name

Last Name

Type of Therapy *

Check all that apply.

Individual

Couple

Family

Availability *

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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.

BCBS PPO

Aetna

Optum/United Healthcare

TrustMark/Allied/Meritain

None