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Request a screening to explore fit and next steps.

Express Interest in the Therapy Group

Please complete the form below to let us know you’re interested.

We’ll review your information and follow up by email with next steps.

Preferred Way to Pay
Use insurance (if possible)
Self-pay

  • If you plan to use insurance, please answer the insurance questions below.

  • If you are planning to self-pay, you may skip the insurance questions.

If using insurance, which best describes your plan?
PPO
HMO
Not sure

You don't need to know the details, we'll review benefits if needed.

If known, name of your insurance plan
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