Therapy To A Tea Waitlist Survey
Therapy To A Tea, Co is honored that you have taken interest in starting or continuing your wellness journey with us. We are located in Washington DC and are only able to service clients in this area.We are not accepting any new client until January 2021. Please complete the survey below so that we may be in contact with you for future scheduling. We are not able to provide an exact timeline, but we are happy to be in contact as we get closer to January.
We center and specialize in providing trauma-informed care to BIPOC Queer and Trans individuals and those in relationship.
Which services are you interested in?
Relationship consultation (friends, colleagues, ex-partners, family members)
Date of Birth
How soon are you looking to book an appointment?
What are some concerns that you are looking to address in therapy?
Have you seen a mental health professional before?
Do you have the following health insurance?
Carefirst Bluecross Blueshield
No, will self-pay for services
Page 1 of 1
Never submit passwords through Google Forms.
This form was created inside of Therapy To A Tea, Co.