New Appointments

Please note that not all therapists are providing in-person visits at this time. See below for information.

Legal Name (as registered with your insurance company) *

First Name Last Name

Preferred Name

First Name Last Name

DOB *

Gender

Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code

Phone Number *

Area Code Phone Number

E-mail *

Known Mental Health Diagnosis

Are you seeking medication evaluation from us? We do not conduct medication evaluations. Please contact your insurance company for a referral. *

No

Primary Reason for Appointment *

Name of Guardian Completing Form if Applicable

Please read these instructions carefully and completely.

Most of our therapists are currently not taking new patients. Please only request appointments with those who are. The therapist you select should also accept your particular insurance in their dropdown menu. You may select more than one available therapist. Thank you.

Click here to view therapists' profiles.

Teletherapy and In-Person

Currently not accepting new patients.

Pam Criswell accepts the following insurances

Boston

Teletherapy and In-Person

Currently not accepting new patients.

Rebecca Dessertine accepts the following insurances

Boston

Currently not accepting new patients.

Emily Russo accepts the following insurances

Boston

Currently not taking new patients.

Dan Halloran accepts the following insurances

Boston

Currently not accepting new patients.

Aria Michaels Paradise accepts the following insurances

Boston

Currently not accepting new patients.

Pamela Boone accepts the following insurances

Boston

Currently not taking new patients.

Louise Binette accepts the following insurances

Boston

Teletherapy

Currently not accepting new patients.

Brendan Clarke accepts the following insurances

Boston

Currently not accepting new patients.

Sarah DeCelles accepts the following insurances

Boston

Teletherapy and In-Person

Currently not accepting new patients.

Jeff Pesaturo accepts the following insurances

Boston

Teletherapy and In-Person

Currently not accepting new patients.

Nicole Ferritti accepts the following insurances

Boston

Currently not accepting new patients.

Athena Weggler accepts the following insurances

Boston

Teletherapy Only

Currently not accepting new patients.

Ana Santos accepts the following insurances

Boston

Teletherapy Only

Currently not accepting new patients.

Britta Baghestani accepts the following insurances

Boston

Teletherapy Only

Currently not accepting new patients.

Barbara Hershey accepts the following insurances

Boston

Teletherapy Only

Currently not accepting new patients.

Marjorie Thomsen accepts the following insurances

Boston

Currently not accepting new patients.

Constance Lum accepts the following insurances

Boston

Teletherapy Only

Currently not accepting new patients.

Kate Schiffman accepts the following insurances

Boston

Teletherapy and In-Person

Currently not accepting new patients.

Cassandra Xanthos accepts the following insurances

Boston

Insurance Member ID/Subscriber Number *

Please upload a photo of the front of your insurance card.

Were you in contact with the therapist you selected and he/she asked you to make an appointment? *

Yes No

Please give us some dates and times that you are available. *

If you are a referring provider, please give us your name and contact information. If you are not, please enter "N/A". *

Please let us know if there is anything else you'd like to share with us (disability accommodation, language needs, etc.).

You may securely upload any pertinent patient information.

How do you prefer us to contact you? *