If you are seeking therapy services, please fill out the form and we will contact you! Name * First Name Last Name Email * Phone * (###) ### #### Age of Service Recipient * What services are you interested in? * Art Therapy Dance and Movement Therapy Music Therapy Other Do you have insurance? Yes No Who provides your coverage? Not all providers are in network with all insurance companies, providing this information helps us match you with a therapist. Why are you seeking services? It is not necessary to provide this information via the form, but it helps us match you with a therapist. (Only disclose what you are comfortable sharing.) Thank you!
