Schedule Online Therapy for Anxiety, Mental Health & Counseling Services
Choose the Right Therapy for Your Needs
Therapy and Appointment Preferences
Which service are you interested in?
Select a service
Therapy
Couples Therapy
Family Therapy
Medication Management
Grief Therapy
Psych Assessment
What are the reasons you're seeking therapy or medication management?
Select a reason
Anxiety
Depression
Grief
Other (Please Specify)
Please specify:
Do you have a preference for a specific gender of therapist?
Select preference
No preference
Female
Male
Is there a particular ethnicity you prefer for your therapist?
(Note: While we cannot guarantee your exact preference, we will make every effort to find the best match for you.)
Appointment Time and Day Preference:
Weekday Mornings (8:00 AM-12:00 PM)
Weekday Afternoons (12:00 PM-5:00 PM)
Weekday Evenings (6:00 PM-9:00 PM)
Weekends (Saturday-Sunday, 9:00 AM-1:00 PM)
How soon would you like to be seen?
Select urgency
Within the next 24 hours
Within next week
Within next month
Contact Information
First Name:
Last Name:
Date of Birth:
Email:
Home Address:
Phone:
Is this a cell phone?
Yes
No
Please upload photo of your Driver's License (Max 2 files):
Insurance Information
Insurance Company Name:
Insurance ID#:
(We are currently enrolled with UPMC and Highmark.)
Submit
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Note:
All required fields must be filled out.