Schedule your Intake Assessment with Erica… Name * First Name Last Name Email * Preferred Date * MM DD YYYY Time * Hour Minute Second AM PM Insurance* * Aetna BlueCross and BlueShield Highmark Optum UnitedHealthcare UHC | UBH None Other What are 1 - 2 goals you want to accomplish in therapy? * Thanks for submitting your Intake Assessment form, I will be in touch within 24-48 hours with additional information and next steps! * We are unable to accept medicare or medicaid health insurance .
