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Who are you contacting us about? *

Myself

Minor Child

Another Adult (not myself)

Which services are you interested in? *

Individual

Couples

Family

IASIS Neurofeedback

What are your schedule needs? *

Flexible

I have specific schedule needs

I have specific preferences but I can also be flexible

What format is your preference? *

In-Person

Virtual

Hybrid of Virtual and In-Person

I'm flexible

Preferred clinician you’d like to see *

I'll let you decide

Robert

Jenny

Catherine

Riley

Kendall

How do you plan to pay for services? *

Out of Pocket (Private Pay)

Health Insurance (BCBS, Aetna, UHC, MultiPlan)

HSA or FSA

Other

If you plan on using insurance please select from the options below?

Blue Cross Blue Shield (for Robert only)

Aetna (for Robert, Jenny, Catherine, Riley, or Kendall)

United (for Robert only)

MultiPlan (for Jenny or Robert)

I agree to my personal health information being accessed and stored securely by Every Body Counseling. *

Yes, I agree