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 *

Phone Number *

Preferred Day(s) *

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

You may select ore than one day.

Please select your preferred time(s) *

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

You may select more than one.

Preferred Method of Contact *

• Phone
• Email
• Either

Comprehensive Care Program or Health Anxiety

• Comprehensive Care Team – Jodi Gibbs, BSW, PA-C, MPAS and Amy Durtschi, M.S., LPC

Nutrition

• Laurie Coleman, RD, LD

Medication Management [except for stimulants & suboxone and cautious use of benzodiazepines, if at all]

• Jodi Gibbs, BSW, PA-C, MPAS
• Justin Kerr, APRN, PMHNP-BC
• Soumi Dey, PMHNP-BC

Counseling – Please Understand Not All Therapists Can Accept New Clients.Select Preferred ProviderAlissa Jackson, LISW-S, RYT 500Allyson Cordle, LISWAmy Durtschi, LPCCAngie Tracy, MSEd, LPCC-SBrittany Ward, MSW, LISWBrock Bauer, LISW-S, SAPBryan Davis, MSEd, LPCC-SDana Acock, MSW, LISWDebbie Helldoerfer, MSW, LISW-S, LICDC-SDr. Michael D. Wagner, Ph.DDrew Moss, EdD, LPCC-S, LICDC-CSGrant Schroeder, LPCC-S, LICDC-CSGreg Ritter, LPCC, LICDC-CSHeather McAtee, M.Ed, LPCC (telehealth only)Jackie Schwartz. LISW-S, LICDC-CSJoe Cleary, SWTJoel Pfeifer, MEd, MSW, LISWJohn Hollis, LISWKade Hirth, LISW-SKaren Merson-Lehman, RN, MS, LPCCKim Wall, MSW, LSWKristina Knight, LISW-SKrystle Collins, LISW-SLisa Zupan, MSEd, LPCLuke Hampel, LPCCMary Rastetter, LISWMary Beth Holt, PhD, LISW-SMaxine Sims, MSEd, LPCCMomina Khatri, SWTNetsanet Chevers, LPCCNicole Parente, LISW-SRenee Ahern, PhD, LPCC-SRick Allen, MSW, LSWSamara Sauls, MSW, LSWSandy Puckett, LPCCSarah Vretas, LPCCShahrzad (Shar) Nabavi, MSW, LISW-STrevor Simmons,, LPCCVelma Valentine, LISW-SWill Crowe, LICDC, SAPAny CounselorAny FemaleAny Male

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.

Preferred Location *

• In Office
• Video Call
• Either

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

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

• Yes
• No

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