Name *

First Name

Last Name

Phone # *

We will reach out to you by phone call.

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I'm interested in... *

Individual Therapy

Couples Counseling

Teen/Adolescent Therapy

Child Therapy

Parent/Family Therapy

Something else/I'm not sure

I'm looking for support with... *

Mental Health

Substance Use

First Responder Experiences

Veteran Experiences

Something else...

I'm not sure...

How I plan to pay for services

Please see the Insurance Information Page linked at the top of this page for more information. Please note that Landmark Therapy Group does not accept Medicaid.

Insurance

Out Of Pocket