Elevate Therapy & Wellness Intro form

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Please fill out the following questions in order to book your initial call.

Please Note:

Grace is an out of network provider. She will provide you with a superbill after each session that you can submit for out of network reimbursement. You can get reimbursed a certain percentage of the session based on your insurance plan.

Email *

Name: First and last *

Phone Number *

Where do you live? *

What are you wanting to address in therapy or coaching? *

Have you been to therapy or coaching before? *

How did you find Elevate Therapy & Wellness? *

Anything else you'd like your therapist to know before your call? *

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

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