SoS Appointment form
Please fill out the following form so we can figure out how best to help you.

Symmetry provides individual counseling (no couples counseling) for adults ages 25 and up but is not able to take medicare/medicaid plans. Symmetry of Self Counseling Center does not provide services related to workers’ compensation, State short term disability, long term disability, or social security disability

Sign in to Google to save your progress. Learn more
**Current Openings**
Athena: She can ONLY take Aetna, MHC, ATAP and Cigna but has a reduced out-of-pocket rate of $90/session for those not in-network. She also cannot do EMDR and can only see clients who are in New Jersey (either in-person or virtual). She has immediate day and nighttime openings!

Heather: She can see NJ (in-person or virtual) and PA (virtual) clients who are looking for EMDR and can be seen in the early afternoons (between 12 and 3)

WE ARE NOT KEEPING A WAIT LIST

Are you a military veteran? *
Where are you located?  *
What is your age? *
First Name *
Last Name *
Email *
Phone number *
What brings you to Symmetry? *
Required
Do you prefer in-person or telehealth services? 
(We are located in West Deptford, NJ) 
 *
Symmetry only takes a few insurance plans and not every clinician is in-network. Our out of pocket fee varies ($90 - $130) depending on the clinician. How do you want to pay for your sessions? (WE ONLY TAKE THE INSURANCES LISTED BELOW, no medicare/medicaid) *
Required
Our hours vary depending on the clinician. What times/days work best for you? *
Required
Are you comfortable seeing a therapist who is under clinical supervision? (The therapist would be under the guidance of a more experienced clinician to help the therapist get their necessary hours towards their clinical license, this often means they can be less costly when it comes to out-of-pocket expenses). There are immediate openings! *
How did you hear about us? Who referred you?
We will get back to you
If you are in crisis please find your nearest emergency room or crisis center or dial 911 or 988. We will get back to you as soon as we can to match you with the best therapist for your needs.
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Symmetry of Self Counseling Center. Report Abuse
Google Forms