Therapy Inquiry - Licensed Therapist
Please fill out this form if you are interested in equine therapy here at Medicine Horse. All information that you provide below will remain confidential and be sent directly to our therapy team. 

This form is ONLY for working with our licensed therapists at a self-pay market rate of $180 per session.
  Sliding scale options are available between $100-$180 per session based on financial need.  See below for more on sliding scale.

Our therapists do not accept Medicaid, and are "out of network" providers with insurance, meaning they do not bill insurance directly, but can provide you with a superbill for reimbursement if your insurance accepts out-of-network psychotherapy services.

Our interns are not currently available to take on new clients, if you are interested in working with our interns, please check our website regularly for updates!
Sign in to Google to save your progress. Learn more
Learn More
At Medicine Horse, we are dedicated to providing affordable therapy tailored to your needs.  Sessions with our licensed therapists are available at a self-pay market rate starting at $180 per session. Sliding scale options are available between $100–$180 per session based on financial need.

**Please note that we are not able to accept insurance at this time.

You can also check out our free support groups that we have available to everyone: https://www.medicinehorse.org/programs.

Your well-being is our priority, and we look forward to supporting you on your journey to wellness.



If you are in crisis, please seek help immediately
  • 1-800-273-TALK (8255) to reach a 24-hour crisis center available through the National Suicide Prevention Lifeline.
  • Text MHA to 741741 to connect with a trained Crisis Counselor from Crisis Text Line.
  • Call 911 or go to the nearest emergency room.

If you are in need of support, but not in crisis, consider reaching out to a warmline. Warmlines offer a place to call when you just need to talk to someone. Speaking to someone on these calls is typically free, confidential, and run by people who understand what it’s like to struggle with mental health problems. Find a warmline at mhanational.org/warmlines.
First Name *
Last Name *
Email *
Phone number *
Relationship to the Client *
Next
Clear form
Never submit passwords through Google Forms.
This form was created inside of Medicine Horse.

Does this form look suspicious? Report