Progress Therapy

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Progress Therapy

A few questions to help me get to know you better! --Sarah Swygart, MA, LMFT

Email *

Phone Number *

How do you prefer to be contacted? *

Phone Call

Text Message

Any of them work

Other:

Full Name *

Date of Birth *

YYYY

Do you live in Indiana? *

Yes

Other:

I accept Anthem BCBS, United Healthcare, Optum, and Cigna insurance. Do you have insurance or will you be self-pay ($110 per session)? *

I have Anthem BCBS

I have United Healthcare

I have Optum

I have Cigna

I will do self-pay

Other:

What times work for you for scheduling? Currently, I offer video sessions only. *

What led you to consider therapy today? *

I feel anxious or overwhelmed

I've been feeling depressed

My mood has been interfering with my job/school performance or my relationships

I have relationship concerns

I am grieving

I have experienced trauma

I need to talk through a specific challenge or life-transition

Recommended to me (family, friend, doctor)

Other:

Required

Please share a summary of why you are seeking therapy. *

A copy of your responses will be emailed to the address you provided.

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