Therapy Inquiry

You have taken the first step in your journey toward wellness!  We are here to help.  This is what you will need to proceed - please have this all together to proceed with establishing services:

  • Valid Picture of Drivers License or State ID of the person or guardian requesting services

  • Valid Picture of Insurance card - front and back

  • Custody Paperwork/Guardianship/Parenting Plan Paperwork/Power of Attorney (if applicable, this IS required)

  • Demographic Information (home address, phone number, email, date of birth of client)

  ***WE NEED A NEW THERAPY INQUIRY FORM FOR EACH PATIENT AND DATE OF SERVICE***