Contact HEART Counseling

In general, what is bringing you to therapy? (You can select multiple options.)

AnxietyBig Life ChangesCouples CounselingDepressionEMDRFamily TherapyGeneral SupportIdentity IssuesIFS or Parts WorkLGBTQIA+ ConcernsParentingPerinatal ConcernsRelationship ProblemsStressTherapy for KidsTherapy for MenTherapy for TeensTherapy for WomenTraumaOTHER

Where are you hoping to go to therapy? *In Person (on the west side of Madison)Virtual/TelehealthOpen to either in person or Telehealth

Are you interested in working with a particular clinician?Savannah ButtermoreElise ReichleSunshine StephensMakayla WiegandJulie JensenRobin KinneyHollie McCrea OlsonAmy RackiAmberly StevensSam EgelhoffNo Preference

Please select the payment method you plan to use if we work together. *Self PayAnthem BCBSAnthem MedicaidDeanDean MedicaidQuartzQuartz MedicaidMedicaidMedicareOptumOptum MedicaidSecurity Health PlanSecurity HP MedicaidUnited Healthcare (UHC)UHC MedicaidOTHER

Reminder: Please do not include personal health information in this form.

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