Join our waitlist
Please complete this form to join our waitlist. The wait can vary anywhere from 2-6 weeks. We will contact you via your preferred method of contact once we have an opening. While we will do our best to match you with your preferred clinician, we cannot guarantee specific therapists for those on the waitlist. Please call 216-245-8249 or email with any specific questions.
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Email *
Client’s Name *
Your name (if different) and relationship to client
Client’s DOB *
Phone number *
Preferred method of contact *
Does the client have insurance? *
Insurance type
Preferred therapist?
How did you find us? *
Is there anything else you want us to know?
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