New Client Request Form
This is a request is you are looking for psychotherapy treatment. It is important to make sure we are a good fit to work together. After this request I will set up a free 15 minute consultation.  If I feel clinically someone else would be of better service to help you on your healing journey I will direct you in the right direction.

Current therapists

Samantha Alzate  LCSW 
Availability: not accepting new clients 
Schedule:  Tuesday- Thursday 8-2 Telehealth and In-Person
Insurance Accepted: Husky, Anthem BCBS, Optum, Connecticare & Aetna 

Lauryn Wille LMSW 
Availability:  Waitlist 
Schedule: Tuesdays and Thursdays 5-8
Insurance Accepted:  Anthem, Husky, BCBS, & cigna 

Erica Teti LMSW 
Availability:  Wait list
Schedule: Mondays (in person) and Thursdays (virtual) 4-8
Insurance Accepted: Currently accepting husky insurance  & Aetna and sliding scale

Cristina Decosta LCSW
Availability:  wait list
Insurance Accepted: Currently accepting  BCBS, Aetna, Husky, out of pocket & out of network

Shannon Macca LMSW 
Availability:  Immediate opening
Schedule:  Tuesday 9-4 pm Wednesday 9-5 pm Fridays 9-2 
Insurance Accepted: Currently accepting   Aetna, Anthem, Husky, & out of pocket 

Stephanie Thibault  LMSW
Availability:  **Immediate opening Telehealth only**
Schedule:  Mondays, Wednesday, Thursday, Friday 8:30-3:30
Insurance Accepted: Currently accepting   Aetna, Husky, Anthem, Cigna & out of pocket 

Kelsy Prucker LPA-A 
Availability:   Immediate openings 
Schedule:  Mondays, Tuesdays, Wednesday 9-5
Insurance Accepted: Currently accepting   Aetna, Husky, Anthem, Cigna & out of pocket 

Brittney LaBonte LPC 
Availability:   Immediate openings 
Schedule:  Friday & Saturday 10-7
Insurance Accepted: Currently accepting   Aetna, Husky, Anthem, Cigna & out of pocket 

Christa Roberts Reiki Practitioner
Schedule: Day time Mondays, Thursdays & Weekends 
Insurance does not reimburse for Reiki Session
 $60.00 for first time sessions $80.00 for regular sessions 
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Name *
Date of Birth 
MM
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DD
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YYYY
Email Address 
What is your current schedule like? When do you see yourself being able to make appointments?
Do you have a specific therapist you would like to see? 
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What state do your currently reside in?
Phone Number
Brief history of treatment
Referral Source, How did you find out about us?
Are you looking for...
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Briefly explain what you are looking for in a therapist and what you hope to get out of therapy
Are you planning on paying out of pocket or insurance?
Clear selection
If you are planning on using insurance what current insurance do you have?
Insurance ID number
Are you willing to be put on a wait list if needed?
Clear selection
Anything else you would like us to know?
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