New Client Information
Thank you for selecting For Us Therapeutics for your mental health services. Please fill out our brief survey and give 24 hours to respond. We are looking forward to working with you. 
Name ( First and Last) *
Email *
Address *
Phone number
What is bringing you in for therapy at this time? *
What kind of therapy are you seeking?
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Which Therapist are you interested in working with? *
Would you like to do in person Therapy or Telehealth? *
What Insurance do you have? *
Best Days and Times to meet? *
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