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Request a Counseling Appointment

Counseling Appointment Request Form

You may utilize this form to request a counseling appointment with a New Rhythms mental health counselor. You will then be contacted by NRTC or directly by an available counselor to schedule an appointment. You are also welcome to review our staff here, and contact a counselor directly. 


While we do our very best to assign you to a counselor based on your needs, we are not always able to accommodate every scheduling or financial need. A counselor will reach out to you within 48-72 business hours after completing this request form. Please note that our first point of contact is generally via email and/or text. If you have not heard from someone within 72 hours of business, feel free to reach out to us! 


Privacy Disclaimer: NRTC is committed to protecting your privacy and maintaining high ethical and legal standards of care. This webform is intended for general inquiries and is not considered part of your clinical record. Web-based forms may not meet HIPAA standards for transmitting sensitive health information. If you prefer a more secure way to request an appointment or share personal information, please contact us directly at info@newrhythmstherapy.com.


Client Birthday
Month
Day
Year
How do you prefer to be contacted? Please select all that apply:

Accessibility/Fee Needs

Please note that NOT all counselors are able to bill insurance directly, and those that do have limited availability. For this reason, you will be asked to select two different financial preferences so that we can assign you to a counselor in a timely manner. 


NRTC offers a wide-variety of payment options in an effort to remain as accessible as possible, to include helping clients receive reimbursements directly, sliding scale options, and accepting Care Credit. You can learn more about these here: https://www.newrhythmstherapy.com/fees-and-accesibility

Please select an option in each of the following dropdown question boxes below:

Please Select your first preference:
Please Select your second preference:
Private Insurance Plan (if applicable)

Scheduling Needs

Appointments are most commonly available on weekdays before 4pm. Some counseling staff offer sessions after 4pm on weekdays.

Faith Integration Preferences

At NRTC, we recognize we serve a community with diverse spiritual needs. Please feel free to read more in our FAQ and to indicate a preference below.

Please select an option below:
No preference
I would like faith-neutral counseling
I would like a counselor trained in integrating the Christian-faith to my mental health care (when appropriate)
I would like counseling for religious trauma and spiritual abuse

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