Waitlist for Santos Counseling
Fill in this form to join our waitlist.  We send emails monthly highlighting staff with openings.  If you request a particular therapist(s), we often send emails when they have an opening.  You only need to fill out the waitlist once--you can choose more than 1 provider name.  

Email *
Name (First and Last) *
Email Address *
Your Phone Number 
Please provide a number we can text and call (ie you are giving consent to be contacted at the number below):  
 *
Services You're Interested In (Check All that Apply)
 *
Required
Location Preference:  Our therapists can provide in-office and tele-health. Please select all locations that could work for you: *
Required
What days and times are you available?  Please check all that apply
 *
Required
Which Insurance Plan Do You Have?  Write the insurance type.
Santos Counseling is in-network with Aetna, Cigna, BCBS, United Healthcare, Optum, CBHA, Medcost & UMR. We can help you navigate out of network coverage as well.
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Do you prefer to work with a specific therapist?  Check any and all below.   (See Counseling Team)
 *
Required
What age range best captures the intended client(s):
 *
How did you hear about us?  
 *
Required
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