Scheduling Team

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Client Name (required)

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Insurance (required)
Blue Cross Blue ShieldTricareMedicareMedicaid Healthy BlueMedicaid WellCareUHC Medicaid (Optum)Medicaid AllianceAetnaAetna State Health PlanCredit Cards, HSA/FSASelf-PayOther ( Out of Network

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Are you looking for Online Counseling, Face to Face Counseling or both: (required)

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Please choose the Service you are looking for: (required)

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If choosing counseling, please select the type:

Adult CounselingCouples/MarriageChild CounselingTeen/AdolescentFamily CounselingDepression CounselingAnxiety CounselingOther

Subject

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