Request a 15-Minute Discovery Call With Wellness Counseling Center

Your Name*

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IMPORTANT (check below)*

I understand Wellness does not accept insurance and is considered an out-of-network provider. If I choose to submit an insurance claim, Wellness will provide a receipt that includes required information and billing codes.

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I understand Wellness offers both In-Person and Online Sessions.

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I understand fees range from $100 – $410 per session depending on the service and therapist I select.

Email*

Phone Number*

Age*

Spouse/Partner Name and Age*

How long have you been together?*

Do you have children?*

Yes
No

What are the ages of your children?

Briefly explain the issues and concerns you’d like to address:*

I am most interested in:

Couples Therapy
Family Therapy
1 Day Couples Intensive
2½ Day Couples Intensive
Individual Counseling
Pre-Marital Counseling

Have you ever been in therapy before?*

Yes
No

If yes, please share with whom plus a few details about your experience:

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You’ve got questions…and we can’t wait to answer them.

Let’s talk.

First, here’s some important information:

You’re invited to use this Discovery Call as an opportunity to understand our process and ask questions about our services.

Ready to schedule?

Complete the form below and receive access to our calendar.