Group Therapy Quick Get to Know You

Name *
Name
Please share your month/day/year, this helps if you are using insurance
Can we leave you a voicemail, text, or email message on this number and email address? *
It is usually a letter followed by six numbers
Currently we do not accept Medicare
Our full rate is $125/hr, we try to accommodate people as much as we can.
We currently are located on the second floor, but do have an office we can use on the 1st floor if needed
This could be a recent event or how you might identify
Group Intake Information
After you fill out this form the group coordinator or therapist will call/email you within 24-48 hours to try and setup a group screen. A group screen is a time for the group coordinator or therapist to learn more about you and share more about the group you are interested in. This is a time to make sure that you are a good fit for the group and the group is a good fit for you. If you are using Medicaid you will need to also go through a intake process with an individual therapist in order to complete Medicaid requirements, such as a treatment plan and a full intake.