TSW - Free Consultation Request Form
Please submit this form to get started with booking your free 15 minute consultation with Brenna Doering, LMHC from That’s So Wholesome Co. 
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Email *
Where did you find That’s So Wholesome Co. (Brenna Doering, LMHC)? *
Required
Who referred you to That’s So Wholesome Co.? Please share the referring person’s full name (if you are self-referred, please state “self”).  *
If someone specific referred you, please share their contact number and email. If you self-referred, please write N/A. *
Client’s full name *
Client’s Date of Birth (DOB) *
Client’s Age *
Client’s Phone Number *
Client’s Email Address *
Client’s Primary Caregiver Full Name (if under 18) *
Client’s Primary Caregiver Phone Number (if under 18) *
Client’s Primary Caregiver Email Address (if under 18) *
Can your therapist leave a voicemail, email, or text message? *
State client resides in? *
Required
Private Pay:
We've partnered with Mentaya, a service that streamlines getting reimbursed for your therapy sessions through out-of-network benefits. They typically reimburse up to 80% of the therapy session fee. By seeing if you qualify, they will tell you what your rates will look like.
     
See if you qualify: https://mentaya.co/checkbenefits/hbhPygNLiSYuKWouYeC4

Mentaya is perfect if you:
    • Have out-of-network benefits
    • Feel overwhelmed by superbills and insurance
    • Have submitted superbills but failed to get any reimbursement
    • Simply want to skip the hassle of paperwork!
   
Here's how it works:
    1. Sign up for Mentaya: https://mentaya.co/inviteclient/hbhPygNLiSYuKWouYeC4
    2. Our practice will enter your sessions into the platform.
    3. Mentaya submits the claim and handles any insurance follow-up.
    4. You get reimbursed by insurance!

Mentaya charges a 5% fee per claim, which includes handling any paperwork required, dealing with denials, and calling insurance companies.
   
It's risk-free: They guarantee claims are successfully submitted, or a full refund of their fees.

Our fees:
Intake/First Session (50-53 mins) = $275
Individual Session (50-53 mins) = $200
Family/Parenting/Couple Session = $250

Feel free to complete this form and use the "other" response for any questions you might have about this process.   
 *
Required
What brings you to seek therapy? (Reason for referral). *
Please share a couple of dates/times that you are available for your free 15 min phone consultation in the next week. (TSW hours are typically 10AM-5PM on Mondays through Thursdays) *
Please share a couple of dates/times that you are available for sessions. (TSW hours are typically 10AM-5PM on Mondays through Thursdays) *
Please share anything else you would like your therapist to know. *
Thank you for filling out this form! I'll reach out to you within the next 48 hours to schedule a 15 minute phone consultation with you/the client.
A copy of your responses will be emailed to the address you provided.
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