Schedule Appointment with Tenisia Name:(Required) Email:(Required) Phone:(Required)Preferred payment method: Blue Cross Blue Shield PPO Aetna PPO Out-of-Pocket In-person or virtual appointment? In-person Virtual Mixed - Virtual and In-person No preference I’m available to make an appointment on (check all that apply): Monday Tuesday Wednesday Thursday Friday Saturday Sunday Preferred appointment time: Morning Afternoon Evening Any Type of Service: Individual Therapy Couples Therapy Family Therapy How did you hear about Tenisia: Web Search Trusted Personal Contact Referral (doctor, psychiatrist, hospital, therapist, health center, etc) Other Specify: If known, reason for seeking therapy:Any additional comments of concerns: Δ
