What is your preferred first name? *

What is your email address? *

What is your telephone number? *

Who referred you?

Which meeting location do you prefer? *
Both are finePrefer onlinePrefer in-person

Which of these times would work best for you? *
Mon 10 AM - 5 PM (in-person)Tue 10 AM - 5 PM (virtual)Wed 10 AM - 2 PM (in-person)Wed 3 PM - 5 PM (virtual)Fri 10 AM - 5 PM (in-person)

Are there any details that would make scheduling easier? (400 or fewer characters)
400

How urgent is your therapy needs? Scheduling for new clients may take up to 4 weeks. *
Within four weeksWithin two weeksWithin one week

Are you planning on using insurance? *
YesNo

If yes, what insurance do you have? The listed plans are the ones I accept in network.
AetnaCignaHighmark (all types)MedicaidMedicareMultiplanTricareUnited HealthcareUPMC

Do you have a preference of therapist? *
No PreferenceRobin Thurman, LCSW, Owner & TherapistChristie Edwards, MS, CAADC, TherapistTishaun Cook, LSW, TherapistKimberlee Kaercher, TherapistZac Mauro, TherapistShruti Talekar, Therapist

Is there anything in particular about a therapist's profile, or specialties, that feels like a good fit for you? (400 or fewer characters)
400

Are you specifically seeking EMDR therapy? *
YesNo

Are you swilling to work on your goals ouside of sessions? *
YesNo

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