Your Name *

First Name

Last Name

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Health Insurance options

Several health insurance plans cover teletherapy. Coaching is out of pocket payments only.

No third party please - I will pay out of pocket for full privacy

I will use my health insurance coverage

I might have out-of-network insurance coverage

EAP

Not sure yet

How did you hear about my services? *

Friend/Family

Community Event/Workshop/Class

Referral from another professional

Health Insurance Company

EAP

General Internet Search

Psychology Today

Social Media (Facebook, Twitter, Instagram)

Other