Appointment Request

Hello! Thank you for your interest in starting therapy at Be Well - Wellness! 

Please share a few details below so we can match you with the best-fit clinician for your needs. Someone from our team will be in touch soon with next steps and scheduling options.

We look forward to connecting and supporting you on your path toward wellness.

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Name
Phone Number
Email Address
Location (City, State)
What services are you looking for?
How did you hear about us?
What is your availability for appointments? (best days, times)
Describe the struggles you are experiencing and your goals in receiving support.
Have you previously been treated for mental health concerns? If so, please briefly describe.
What is your preference for appointments:
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Insurance Company
Anything else you'd like us to know?
Would you like to be added to Megan's mail-list to receive occasional newsletters with tips, tools, and information? (Unsubscribe at anytime).
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