Telehealth Scheduling Request
Please fill out this form to get the scheduling process started for Telehealth! Our admin staff will contact you within 1 business day to complete your request.
First Name
Last Name
Name of Client if Scheduling for a Minor
Age of Client
What appointment day/days work best for you?
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Requested appointment time (Morning, afternoon, evening)
Insurance Provider
Blue Cross Blue Shield (We do not accept Blue Cross Complete-Medicaid)
Blue Care Network
Aetna
Priority Health (We do not accept Medicaid plans)
UnitedHealthcare (We do not accept Medicaid plans)
Private Pay
Which therapist would you like to schedule with?
Renee Edgar (accepts BCBS, BCN, Aetna, Priority Health, UnitedHealthcare and private pay)
Amanda Eder (Accepts BCBS, BCN, Aetna, Priority Health, and Private Pay)
Hannah Bonenfant (Accepts BCBS, Aetna, Priority Health, and Private Pay)
Ghazaleh Akbarian (Accepts BCBS, Aetna, Priority Health, and Private Pay)
Jennifer Seim-Andrew (accepts BCBS, BCN, Priority Health, and Private pay)
Amanda Yats (Accepts BCBS, Aetna, Priority Health, and Private Pay)
Isabella Andrew (Accepts BCBS, Aetna, Priority Health, and Private Pay)
Mitchell Hession (Accepts BCBS, Aetna, Priority Health, and Private Pay)
Anna Veenhuis (Accepts BCBS, Aetna, Priority Health, and Private Pay)
Evonnia Evans (Accepts BCBS, Aetna, Priority Health, and Private Pay)
Chloe Nicholls (Accepts BCBS, Aetna, Priority Health, and Private Pay)
Joe Arocho (Accepts BCBS, BCN, Aetna, UHC, Priority Health and Private Pay)
Susie Stevenson (accepts BCBS, BCN and Private pay)
Kelsey Tappenden (Accepts BCBS, BCN, Aetna, UHC, Priority Health, and Private Pay)
Lauren Ruttenberg (Accepts BCBS, Aetna, Priority Health, and Private Pay)
Shannon Samuels (Accepts BCBS, BCN and Private Pay)
No Preference
What is the reason you are seeking Therapy?
Phone Number
Email
Preferred Method of Contact
Phone
Email
Submit