Request edit access
New referral information
I am happy that you are interested in counseling with me, Dr. Elizabeth Grady, LPCS, with eSupport Counseling! The details you provide here will allow me to better understand your particular needs & goals. The details will also help me check your insurance coverage and answer any financial questions you may have before counseling begins.
Is online counseling right for you? Review this quick checklist to determine if traditional office therapy may be more suitable for you than online counseling. *
Required
I reside in North Carolina *
Next
Never submit passwords through Google Forms.
This form was created inside of eSupport Counseling. Report Abuse