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Request an appointment
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First name
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Last name
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Date of birth
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Preferred pronouns
Email
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Phone
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Best way to reach you
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What you're looking for
I'm looking for
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Therapy / Counseling
Psychiatry / Medication management
Both therapy and psychiatry
Not sure
Preferred location
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Monroe, MI
North Canton, OH
Perrysburg, OH
Toledo, OH
Virtual / Telehealth
No preference
Preferred provider
No preference
Alicia Kirk, NP (FNP + PMHNP)
Asha Pearson, LSW
Brittney (Britt) Portala, LISW
Donnell (Don) Gemus, PA-C
Emily Wegert, LSW
Hanna Ochs, LSW
Lynda Nunez, LMSW
Meredith Rinna, LMSW, LISW-S
Monica Boik, LLMSW
Rain (Jonnie) Glynn, LLMSW (MI), LSW (OH)
Riann Tennyson, LLMSW
Samantha (Sam) Habusta, LSW
Samantha Beaton, LLMSW
Sarah Bollenberg, LMSW
Savannah Fraunfelter, LLMSW
Varalyn (Vara) Kaiser, MSW, LSW
Insurance plan
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Aetna (not Aetna Better Health Medicaid)
Blue Care Network
BlueCross BlueShield of Michigan
Blue Cross Complete
Optum
Paramount
Priority Health
Surest
TriCare East
UnitedHealthcare
UMR
Aetna
Anthem
Beacon
Blue Care Network
BlueCross BlueShield
Buckeye
Humana Medicaid
Medical Mutual of Ohio
OhioRISE
Optum
Paramount
TriCare East
UnitedHealthcare
UMR
Cigna (temporary acceptance)
EverNorth (temporary acceptance)
Meridian of Michigan (temporary acceptance)
Self-pay
Other / not listed
Availability (days/times that work best)
What's bringing you in?
How did you hear about us?
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Google search
Social media
Doctor / provider referral
Friend or family
Insurance directory
Psychology Today
Other
I understand this form is not for emergencies. If I am in crisis, I will call
988
or go to the nearest emergency room.
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