New Client Intake

Please complete our New Client Intake Form to schedule a free 15-minute consultation with Jessica Oakley. This brief call allows us to discuss your therapy goals, answer any questions, and determine if our services are the right fit for you. Your journey toward growth and authenticity starts here—complete the form below to schedule your consultation today.

Name

First Name

Last Name

Email

Phone

(###)

###

####

What is your birthday?

MM

DD

YYYY

Please describe why you are seeking counseling services at this time.

As payment is due at the time of service, please indicate if you plan to pay with insurance or self pay.

If you plan on paying with insurance, who is your insurance provider and which plan do you have?

We currently accept plans from Optum (United and UMR), Aetna, Cigna, Blue Cross Blue Shield, Carelon Behavioral Health, Quest Behavioral Health, and Select Health (Care, Choice, Share, Med, and Value).

Where did you hear about our services?

New Client Intake

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