Vibe’s Appointment Request

To schedule an appointment or to obtain additional information about services, please fill out the form below or call 614.940.4868. Please understand our availability can quickly change for many reasons. We will do our best to accommodate you but may be unable.

We strive to reach you within 1 to 3 business days, if not sooner. Please reach back out if you have not heard from us within 3 business days.

Name *

First

Last

Email *

Please of Is

Phone Number *

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Preferred Day(s) *

• Monday
• Tuesday
• Wednesday
• Thursday
• Friday
• Saturday
• Sunday

You may select ore than one day.

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Please select your preferred time(s) *

• Early Morning
• Late Morning
• Early Afternoon
• Late Afternoon
• Evenings
• Weekends

You may select more than one.

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Preferred Method of Contact *

• Phone
• Email
• Either

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Medication Management [cautious use, if any, of stimulants & suboxone and benzodiazepines, will be given by our provider]

• Jodi Gibbs, BSW, PA-C, MPAS
• Taylor King, DO (starting Summer 2025)

Please select your top choice but understand the availability of our prescribers can vary quickly based on your request times to meet, your insurance, etc.

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Counseling – Please Understand Not All Therapists Can Accept New Clients.Select Preferred ProviderAmy Durtschi, LPCCChristina Jasik, LPCChristine Belanga, MSW, LSWCori Hemmelgarn, LPCC, ATR-PKate Streim, MSW, LSW (Not accepting new clients)Mary Rastetter, LISWNicole Parente, LISW-SNicole Wilson, LPCVirginia Pishioneri, MFTAny Counselor

Please select your top choice but understand the availability of our counselors can vary quickly based on your request times to meet, your insurance, delivery of service, etc.

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Preferred Location *

• In Office
• Video Call
• Either

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Please provide any important notes below to help us understand how we can assist you.

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Is it ok to leave you a voicemail if you don't answer? *

• Yes
• No

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