New Appointments

All Appointments are Currently in Teletherapy

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Information submitted through this form is encrypted and confidential. We need to collect this information in order to verify your insurance so that your appointment can be seamless when you arrive.

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 Country

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.

Below are the therapists who are currently accepting new patients. Please select the one you'd like to see and we will contact you to make an appointment with that therapist. You may select more than one.

Click here to view therapists' profiles.

Pam Criswell, LMHC

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Only accepting new patients who have been pre-screened by therapist.

Pam Criswell accepts the following insurances

Boston

Nicole Ferretti, LMHC

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Tuesdays through Fridays: 10:00 - 6:00pm

Saturdays: 9:00 - 5:00pm

Nicole Ferritti accepts the following insurances

Boston

Britta Baghestani, LMHC

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Only accepting new patients who have been pre-screened by therapist.

Britta Baghestani accepts the following insurances

Boston

Barbara Hershey, LICSW

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Only accepting new patients who have been pre-screened by therapist.

Barbara Hershey accepts the following insurances

Boston

Dan Halloran, LICSW

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Mondays/Wednesdays/Thursdays/Fridays: 10:00 - 4:00pm

Dan Halloran accepts the following insurances

Boston

Ana dos Santos, LMHC

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Mondays, Tuesdays, Thursdays: 12:00 - 3:00pm

Ana Santos accepts the following insurances

Boston

Athena Weggler, LMHC

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Mondays through Thursdays: 9:00 - 3:00pm

Athena Weggler accepts the following insurances

Boston

Emily Eldar, LMHC

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Only accepting new patients who have been pre-screened by therapist.

Emily Eldar accepts the following insurances

Boston

Marjorie Thomsen, LICSW

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Only accepting new patients who have been pre-screened by therapist.

Marjorie Thomsen accepts the following insurances

Boston

Jeff Pesaturo, LMHC

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Only accepting new patients who have been pre-screened by therapist.

Jeff Pesaturo accepts the following insurances

Boston

Constance Lum, LICSW

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Only accepting new patients who have been pre-screened by therapist.

Constance Lum accepts the following insurances

Boston

Kate Schiffman, LMHC

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Only accepting new patients who have been pre-screened by therapist.

Kate Schiffman accepts the following insurances

Boston

Brendan Clarke, LMHC

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Only accepting new patients who have been pre-screened by therapist.

Brendan Clarke accepts the following insurances

Boston

Cassandra Xanthos, LICSW

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Only accepting new patients who have been pre-screened by therapist.

Cassandra Xanthos accepts the following insurances

Boston

Insurance Member ID/Subscriber Number *

Please upload load a photo 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? *