Request a 15-Minute Discovery Call With Wellness Counseling Center

I understand Wellness does not accept insurance and is considered an out-of-network provider. *

I understand if I choose to submit an insurance claim, Wellness will provide a receipt that includes required information and billing codes. *

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: *

Pre-Marital Counseling

Week-to-week Couples Therapy

Family

1 Day Intensive

2 1/2 Day Intensive

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…we’ve got answers! PLUS, we want to be sure Wellness is the right fit for you.

Important Information:

Ready to request a Discovery Call and schedule an appointment?

Complete the form below and you will receive access to our calendar to schedule your Discovery Call.