Get Started

Name *

First Name

Last Name

I am... *

Seeking counseling for myself

A parent or guardian seeking counseling for my adolescent child

Phone *

(###)

###

####

How do you prefer I contact you? *

Phone (usually respond within 48 hours)

Email (usually respond same day)

Phone or Email is fine

May I leave you a voicemail if I cannot reach you?

Yes

No

I prefer that you email me

Form of Payment *

In Network Premera Blue Cross (deductible and copay may apply)

In Network Kaiser PPO/First Choice Health (deductible and copay may apply)

Out of Network with other insurance (full fee due at time of service and you submit invoice for reimbursement from your insurance plan).

Private pay of $150 per session.

I have questions about this.