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Mother and Daughter

Appointment

Invest in yourself, you are worth it! To keep therapy accessible; I offer a sliding fee scale ranging from $150 to $180 per session. I can also provide a Superbill for potential reimbursement of services to submit to your insurance. Please complete the appropriate intake and request forms below to schedule an appointment, and I will reach out to you as soon as possible to find a mutually convenient time.

Request an Appointment

Intake Forms

Print and complete the appropriate intake form. Scan completed form and upload the signed form.

To e-fill & sign, you need Adobe Acrobat. Download here:

If you are unable to complete the form(s) online, bring the completed form(s) to your appointment.

Preferred Date and time
Month
Day
Year
Time
HoursMinutes
Appointment is for...
Adult
Minor
Couple
Family
Court Ordered
Requesting
In-person Session
Tele-health Session

Please do not submit any Protected Health Information (PHI).

By clicking send you agree that the phone number you provided may be used to contact you (including autodialed or pre-recorded calls). Consent is not a condition of purchase.

“Our wisdom does not just come from what we learn. It also comes from what we unlearn.”
~ Cleo Wade

JENNY CLEARWATER LOGO

Information provided by Jennifer Clearwater of Beautiful Evolution Therapy

Jenny Clearwater photo
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