Request an Appointment

Appointment Request

Please complete the brief form below to request an appointment at either of our locations in Columbia or Lexington South Carolina. Telehealth option only available to those residing in South Carolina.

If you do not hear from our office by phone or by email within 24 hours (not including weekends and holidays), there may be a technical glitch. Please call us at 803.814.5559.

We are so happy you are reaching out and we want to get you scheduled.

Please note we are a private pay and do not accept insurance.

We will provide you with a “superbill,” allowing for submission to your insurance for possible reimbursement.

Fees are $150.00 per 50 minute session.

(Exceptions are senior level therapists, Terri Hallman $175.00 and Jill Smith 250.00)

“*” indicates required fields

Consent Agreement

You will be asked for a credit card to hold your appointment. You will be charged using this card for your appointment if it is not kept.

Do not enter your credit card details here. Email is not secure. We will get your card number by phone when we talk to you about your appointment time.

Our appointments fees range from $150-$250 per 50 min. session. We can happily give you a superbill for possible insurance reimbursement.

I have read the above and consent to hold my appointment

Name of Person Requesting Appointment

Last Name

Requestor’s Email Contact

Requester’s Phone/Mobile

Are you making this appointment for yourself?

Preferred Location

Client First Name

Client Last name

Client’s Age

Date of birth

Client Address

Address Line 1

Address Line 2

City

State

Zip Code

Briefly, tell us how we can help you?

Client’s Name or Doctor’s Referral Name

Other

Additional comments

Consent Agreement

Types of therapy

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Request an Appointment

Consent Agreement

Types of therapy

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