Select a 15 minute time frame that works for you to connect with our Care Coordinator.
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I am seeking therapy for:
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Individuals
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Therapy preference:
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Video
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In-Person Location
New York City, NY
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Personal Information
Full Name
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First Name
Last Name
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Month
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Birthday
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Phone Number
Format: (000) 000-0000.
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Email
Insurance Information
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If you want insurance support, please provide us with the following:
Member ID
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Date of Birth
Questions to help us match you with the right therapist:
If you could have one outcome from therapy, what would it be?
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What are your needs now that are bringing you to therapy?
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Are you currently seeing any other mental health providers or have you in the past?
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