Reconsent for Parents and Guardians

Contact Information

North Liberty Office
595 Ashley Court, Ste 5
North Liberty, IA 52317

Cedar Rapids Office
375 Collins Road N.E., Ste 103
Cedar Rapids, IA 52402

Monday 9AM – 5PM
Tuesday 9AM – 5PM
Wednesday 9AM – 5PM
Thursday 9AM – 5PM
Friday 9AM – 5PM

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Name

Email

How did you hear about us?

Bing search Google search Psychology Today Referral from a family member or friend Referral from a healthcare provider

Location

Cedar Rapids office North Liberty office Telehealth

What days and times (i.e., morning or afternoon) can you attend therapy?

Insurance

Blue Cross or Wellmark Cigna Health Partners Medicare Midlands Choice Out of pocket (private pay)

Phone

What is the best way to contact you?

Email Phone call Text message

Why therapy?