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Be the First to Join our Groups & Therapy

Thank you for your interest in The Stand! We’re excited to begin offering both individual and group therapy this fall in our new location. Please complete this short form to join our waitlist. Once space is available, we’ll reach out to schedule a consultation.”

Contact Information

First & Last Name

Email Address?

Age

Phone Number (Used only for texts & reminders)

Preferred Method of Contact

Service Interest

What Services Are You Interested In?

What Services Are You Interested In?

Currently, we are not accepting insurance, as that would force us to increase our prices. Would you be willing to explore payment options to pay out of pocket?

Currently, we are not accepting insurance, as that would force us to increase our prices. Would you be willing to explore payment options to pay out of pocket?
A
B

Preferred Dates & Times (Please Check the Days of The Week You're Available for Sessions & Their Corresponding Times)

Preferred Dates & Times (Please Check the Days of The Week You're Available for Sessions & Their Corresponding Times)

How did you hear about The Stand Mental Health Consulting?

I understand this form adds me to The Stand’s waitlist and does not guarantee immediate services. I consent to be contacted when space becomes available.

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