New Client Form

Starting counseling is simple!

Fill out the New Client Form, and our intake coordinator will contact you ASAP to schedule your 1st appointment.

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Can’t wait to start counseling?

Access our secure scheduling portal here to complete the new client paperwork and select your 1st appointment with the therapist you’d like to see.

Name

First Name

Last Name

Phone

(###)

###

####

Child's Name (if seeking child or teen therapy)

How should we contact you?

Let us know the best way to reach you to schedule your 1st appointment.

Type of counseling?

Insurance Provider?

We are only in-network with Aetna and BCBS. ***If other insurance select N/A***

Select therapist? (Jessica Zheng is no longer taking on clients under 18yrs old)

Please choose a therapist from the menu below. ***If no preference, select N/A.***

What concerns do you want to bring up in counseling?

How can we help you?

How did you find us?

By submitting this form you consent to receive information from Sweetgrass Therapy.

This is limited to scheduling a 1st session. We respect your privacy.

Sweetgrass Therapy - mental health counseling in the Western suburbs of Chicago.

clientcare@sweetgrass-therapy.com
(630) 480-6444 x 200

800 Roosevelt Rd - Building A, Suite 214
Glen Ellyn, IL 60137

New Client Form

Starting counseling is simple!

Can’t wait to start counseling?

SWEETGRASS THERAPY