Request an Appointment We can’t wait to hear from you!Call (908) 652-5311 or send an email with the form below.Our admin, Jamie, will be your first point of contact. Your name: * First Name Last Name What state do you live in? (If your state is not listed, then we are not licensed to provide therapy in your location at this time.) * Alabama Arizona Arkansas Colorado Connecticut Delaware District of Columbia Florida Georgia Idaho Illinois Indiana Kansas Kentucky Maine Maryland Michigan Minnesota Mississippi Missouri Nebraska Nevada New Hampshire New Jersey North Carolina North Dakota Ohio Oklahoma Pennsylvania Rhode Island South Carolina Tennessee Texas Utah Virginia Washington West Virginia Wisconsin Wyoming I am interested in: Individual therapy Couples therapy Family therapy I would like to work with: No preference Lillian Babcock, LPC Theresa Butler, LPC, CAADC, NCC Elizabeth Hahn, LCSW Lydia Jordan, LCSW, LCADC Dr. Elizabeth Pearce, PsyD Bonnie Jantzen Briefly, what concerns or issues would you like to talk to a therapist about? * Your email address: * The best phone number to reach you: * (###) ### #### May we leave a detailed message when we call this number? (If no, we will leave a general message including the name of the practice and asking for return of our call.) * Yes No What is your preferred way for us to contact you? Email Phone Our therapists are out of network with insurance plans. We encourage you to contact your insurance company to ask about whether you have Out of Network Benefits. We collect session fees at the time of service, and provide you with a detailed invoice to submit to your insurance for reimbursement. Which of the following most applies to you? * I DO have Out of Network benefits. I do NOT have Out of Network benefits. I plan to pay out of pocket for session fees. I do not know whether I have Out of Network benefits, but I'd like to find out. (We can help!) I plan to pay out of pocket, without submitting for insurance reimbursement. We are not set up to work with Medicaid and Medicare plans. We will need to refer you elsewhere for services, or have you sign a private contract acknowledging that you will pay out of pocket for all fees. Is your insurance plan a Medicaid or Medicare plan? * Yes No Finally, how did you hear about Grace Behavioral Health? * Google/Internet search Psychology Today Focus on the Family AACC/Christian Care Connect TheraVive Directory GoodTherapy Directory Friend or family Another professional (physician, psychiatrist, etc.) Office is convenient/noticed while driving by Other Thank you for getting in touch! We try to respond within 24 hours, excluding weekends and holidays. We look forward to connecting!
