Contact — Thrive

Email

Subject

Name your inquiry

Main Mode of Therapy

Please let us know if there is a specific style of therapy you prefer

Depending on availability, which clinician would you like to contact?

Please Choose

Who is Your Insurer? Please select how you will be covering your services.

If you don’t see your insurance company listed, we don’t currently accept your insurance. We can still help you find a licensed therapist if you can pay for therapy yourself (some plans will reimburse you for the sessions).

What is your Insurance Member ID Number?

Please enter to expedite benefits check process

Where do you prefer to see your therapist?

What are specific upcoming times this week and next that you can see someone?

In general, what is your weekly availability for sessions (times and days)?

Please include anything else we should know. This will help us to match you with a therapist.

Have you have been recently hospitalized for mental health issues or hospitalized in the past?

Are you currently feeling like you could hurt yourself or someone else?

Have you had any suicide attempts in the past?

Are you currently experiencing abuse and/or domestic violence in your home?

Are there any other providers involved in supporting your mental health journey ( social services, legal support, nutritionists, prescribers, psychiatrists, or doctors)?

If you are filling this form out for a child please let us know this and provide their age and their contact information if they are 12-17 (email and phone number).

If you are a parent filing out this form for your child, are you in a high conflict divorce, custody process, and/or have a high conflict coparenting relationship with your child's parent?

If you are filling out this form for yourself and a partner and requesting couples therapy, please provide their name (email and phone number.)

If you are a parent filling this out for your child, is your child adopted or a foster child?

If you are a parent filling this out for your child, what is your birthday for insurance billing purposes?

Contact us.