Application for Therapy

(This page, and the following, are confidential and private)

I agree to terms & conditions provided by the company. By providing my phone number, I agree to receive text messages from the business.

Which of the following best descripbes your current relationship status?

Please tell us a little bit about yourself, so that we can better understand your situation.

Can you tell me about yourself, and why you are looking for guidance at this time?

Thank you!

Since we only have a limited number of spots available to work with new couples, what you are looking to achieve as we work together?

Again, please be as detailed and specific as possible. What's your vision or dream here? What would you define "success" as?

As mentioned before, spots are limited, only becuase there's only so much space available in the schedule. Why should we consider accepting you for one of those spots?

What makes your readiness for this work unique or apparent?

The private pay rate for counseling sessions is $125/50 minute session. The insurance plans accepted by Josh are listed below. If yours is not listed, it is possible you may be eligible for out-of-network reimbursement through your insurance plan. Once you complete the questionnaire, you will be take to a screen where you can select to verify out-of-network coverage.

Josh currently accepts the following insurance:

Check the box indicating which insurance coverage or payment option you will be choosing.

Not finished yet...

Last (And Most Important) Step!

Select A Time For A Consultation Call On Our Calendar

It is important to Josh to understand a little bit more about your situation before moving forward with establishing therapy services. For this reason he would like to schedule a free consultation done via zoom or in person. For couples counseling, BOTH partners need to be present for the consultation.

STEP 1

On the next page, PICK OUT A TIME that works with your schedule.

STEP 2

We'll contact you almost immediately to confirm your time, and provide you with a zoom link to your confidential consultation room (held by video). If you prefer to meet in person, please reply to the email or text letting Josh know you would like to do the consult at his office.