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Waiting List
Thank you for your interest in our services. At this time, we are at capacity, but we invite you to join our waiting list. Please complete the form below, and we will reach out as soon as an opening becomes available.
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Email
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Your email
Date:
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MM
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DD
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YYYY
Full Name (First and Last)
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Your answer
What service are you interested in?
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Individual Therapy
Couples/Family Therapy
1:1 Holistic Life Coaching
Attachment Focus EMDR Therapy
Group Coaching Program (S.O.U.L)
Parenting Support Group (Mindful Motherhood)
Clinical Supervision
FEAR: A CBT Skills Group
Discover You! Support Group for Women
Wellness Tree Bookclub
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What insurance do you have?
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United Healthcare
Cigna
Aetna
Emblem/GHI/HIP
Out of Pocket
Other:
What is your best contact number?
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Your answer
What is your email address ?
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Your answer
Availability (select all that apply)
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Weekday morning
Weekday afternoon
Weekday evenings
Weekend mornings
Weekends afternoon
Other:
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Would you like to join our mailing to receive emails from Wellness Tree Counseling about newsletter, new services, special offers, and wellness events?
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A copy of your responses will be emailed to the address you provided.
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