Begin here.

Name *

First Name

Last Name

Phone *

(###)

###

####

Are you located in Michigan? *

Yes

No

Preferred counselor? *

Andi Grandy LMFT, LPC - not accepting new clients at this time.

Matt Stoel LMSW - individual clients only

Angie Grutter, LLPC, LLMFT - individual clients only

If you are hoping to use your insurance, what insurance carrier do you have? *

BlueCross Blue Shield

United/Optum HealthCare

Priority Health

McLaren Medicaid

Meridian Medicaid

Priority Health Medicaid

straight Medicaid

Not Listed/Out of Network - Cost will be $150/session.

If you could not select insurance above or if you do not want to use your insurance benefits, the cost per session will be $180 for the first session and $150 after that. Services can be paid by HSA/FSA, check, or credit card. Are you able to invest $150 per session at this time? *

Yes, I can pay the full fee.

No, I would be unable to pay the full fee.

Are you looking for a specific type of therapy? *

You may choose more than one.

In-Person

Teletherapy

Individual therapy

Parenting support

Family therapy

Couples therapy

Sex therapy

Pre-marital/ Pre-Commitment preparation

Gottman methods

Emotionally Focused Therapy

Are you concerned about your or your loved one's eating habits? Is this something you would like to address in therapy? *

Yes

No

Are you concerned about your or your loved one's alcohol or drug use? *

Yes

No

What age range best describes You or the person you are seeking treatment for? *

11-14

14-18

18-29

30-39

40-49

50-59

60+

Do you have a time of day that you prefer to meet? Check all that apply. *

Morning

Lunchtime

Afternoon

Evening

Sundays