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Let’s Find the Right Fit

This form helps us understand what you’re looking for so we can match you with the therapist who best fits your needs.
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It’s a bit more detailed, but it allows us to make the process smoother and more personalized from the start. (And avoids some phone tag!)

Before you begin:


If you plan to use insurance, you’ll be asked to upload a photo of your insurance card.

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​​​Prefer a simpler way? 👉 Start here instead

New Client Interest Form

This form helps us gather the information we need to begin the matching process.

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Once you complete it, you’ll be able to schedule a call with us to review availability and book your first appointment.

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If you are experiencing a life-threatening emergency, please call 988, 911, or go to your nearest hospital. 

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Please include only basic contact information in this form. We’ll discuss your needs in more detail during your call. Submitting this form does not establish a therapeutic relationship or guarantee services.

Age range of prospective client (s) Required
Contacting us about? Choose 1 or More: Required
Service(s) you are interested in, check all that may apply: Required
Preferred location(s) for therapy appointments - check all that you are open to: Required
Days of the week you are available for appointments Required
Times you are available for appointments: NOTE - Appointments after 2:00pm are in high demand and are rarely available. Please let us know all of your availability so that we can work to find a time that fits your schedule!** Required
Preferred Provider Required
Form of Payment: ***Note the insurances listed are the only ones we accept and this can vary based on the individual provider and meeting medical diagnosis criteria.** Required
Upload File
File Type: .bmp,.gif,.heic,.heif,.jfi,.jfif,.jpe,.jpeg,.jpg,.png,.tif,.tiff,.webp (25 MB Max)
Upload File
File Type: .bmp,.gif,.heic,.heif,.jfi,.jfif,.jpe,.jpeg,.jpg,.png,.tif,.tiff,.webp (25 MB Max)

The next step is to choose a time for us to call you.

 

Upon clicking 'Submit', you'll be directed to a page where you can choose a convenient time for our call. This helps us avoid phone tag!

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During this brief administrative call with our intake coordinator, we will go over clinicians availability and get you scheduled for your first session. 

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