Book An Appointment - Thrive Therapy Studio

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Request an appointment with Thrive by filling out your info below…

Your Name:*

Client's Name:*

Age of Client:*

Phone Number:*

Email Address:*

Form of Payment:*

What insurance do you carry?*

Which type of therapy are you seeking?*

What is your preferred appointment time for ongoing appointments?*

Preferred Therapist:*

How did you hear about us?*

Please 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.

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