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BOOK AN APPOINTMENT

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Type of Therapy
Plan on using Insurance?
Location of Services

*Please note this form is not HIPAA compliant.

What to expect after you complete this form?

 

Within 23hrs You will receive a “Client Portal Invitation” email

Create a login and password

Read and Electronically sign Disclosure and Consent forms

Fill out the Demographic and History intake documents

Complete Payment Authorization Form

Conveniently schedule an appointment that works for you.

Every step of the process is done electronically in an effort to collect the required legal documentation; without exhausting you. Please make sure to complete all the required electronic forms; as any incomplete paperwork will delay the scheduling of an appointments.

Already an existing client? Please click the link below to schedule an appointment.

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