Book An Appointment Let’s Talk Request an appointment with Thrive by filling out your info below… Your Name:* Client's Name:* Age of Client:*Select an option0-5 Years old5-9 Years old10-13 Years old14-18 Years old18-24 Years old25+ Years oldPhone Number:* Email Address:* Form of Payment:*Select an optionPrivate PayInsuranceWhat insurance do you carry?*Select an optionCignaOtherSorry, we don't take your insurance. Please consider private pay.Which type of therapy are you seeking?*Select an optionTherapy for AdultsTherapy for TeensTherapy for ChildrenFamily TherapyParent ConsultationGroupsWhat is your preferred appointment time for ongoing appointments?* Preferred Therapist:*Select an optionDr. Erica WollermanDr. Maria FowlksJennifer Gonzalez, LMFTYing-Ying Shiue, LPCCKim Macias, LPCCAbbey Stewart, AMFTRachel Cratsenburg, AMFTCharlotte Stern, APCCNo preferenceHow did you hear about us?*Select an optionGoogle SearchCurrent / Past Client ReferralFriend / Relative ReferralPhysician ReferralSchool ReferralTherapist ReferralSocial Media (Instagram, Facebook, TikTok)OtherPlease list who referred you* Please share your reasons for seeking treatment in as much detail as you are comfortable sharing*Email Risk Acknowledgement & Use Consent* I understand that the use of email is inherently insecure and thus poses a risk to the security and confidentiality of my protected health information and consent to Thrive Therapy therapists and/or office staff communicating with me via email. CAPTCHANameThis field is for validation purposes and should be left unchanged.
