Let’s Connect! Name * First Name Last Name Email * Phone (###) ### #### You are reaching out for which type of therapy? Therapy for child or teen Individual therapy for myself Couples Therapy Family Therapy Parent Support Briefly, what leads you to reach out for therapy? How will you pay for therapy? I will use my insurance through Aetna, BCBS, DHS (Medicaid), Health Partners, Medica, UHC, UMR, or United. I will pay out of pocket without involving insurance I will pay out of pocket and would like a superbill to submit to my insurance for out-of-network benefits. As a small private practice, we do not have the legal resources available to practitioners in larger agencies, so at this time we do not provide therapy to children whose parents have open divorce or custody proceedings. If you have open proceedings, please let us know, we're happy to provide referrals! If your proceedings are complete, we can absolutely work together, just let us know you've completed a divorce as it helps in planning an appropriate intake process. We are currently in the process of divorcing Our divorce has been finalized We have open custody proceedings/we intend to pursue changes in custody Not applicable Clinician availability: Please indicate any session times you are interested in with either Hannah or Lauren. Note--Hannah does not provide Theraplay Hannah Mondays at 1:30 Hannah Mondays at 2:30 Hannah Mondays at 3:30 Hannah Mondays at 4:30 Lauren Tuesdays at 1:00 Lauren Tuesdays at 3:00 Lauren Thursdays at 11:30 Lauren Thursdays at 1:00 Thank you! I look forward to connecting. I will reach out to you via email within 3 business days.
