Generations Counseling - New Client Information
Please use the form below if you are reaching out to inquire about counseling with us. If you have either reached out to an individual counselor or have a specific individual in mind to work with, please contact them directly and do not fill out this form. You can find our counselors and their contact information here. 
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Your Name (First and Last) *
Your age *
Email Address *
Phone Number *
Do you have a preference on the gender of your counselor? *
What type of counseling are you interested in?
Do you have a location preference? *
Required
Appointment Availability: *
Required
Are you looking to use your insurance? (Please note, no counselor who takes insurance is available to take new clients at the moment) *
If you are planning on using insurance, who is your provider? (Please note, the only plans we are able to process claims for are United Healthcare and Anthem/Blue Cross Blue Shield. )
If there are no counselors available who accept insurance, are you willing to pay out of pocket? *
We also have graduate-level interns under professional supervision who offer a reduced rate. Are you open to meeting with one? *
Do you have a counselor who you think will be a good fit?  Please note, your choice might not be available but we will do our best to match you with the best counselor with the availability that matches your preferences. 
Please share a little about what you are seeking help with? *
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