top of page

Wavecrest

Home
Buy the Book
Contact
- Appointment Request
- General Contact
About
En espanol
Blog & IG
The Fellowship's Site
More

Use tab to navigate through the menu items.

Contact/

Appointment Request Form

Please fill out the following to request an appointment and reduce wait time for a response.

Name

Email

Phone, only if preferred contact

Service Type *

Individual Adult

Individual Minor 10 and up

Couples/ Relationship

Emotional Support Animal

Evaluation only

Other

Meeting Preference *

In Person Only

Telehealth Only, available in Virginia

I'm open to both

Payment/ Insurance *

Self Pay, no insurance

Self Pay, with documentation for insurance

Anthem or BCBS

UHC

Aetna

Oscar

Oxford

Medicaid or Medicare, not accepted

Other

Indicate your typical availability, select all that apply

Flexible/ varied schedule

Monday morning 9a-12p

Monday afternoon 1p-4p

Monday evening 5p or later

Tuesday morning

Tuesday afternoon

Tuesday evening

Wednesday afternoon

Wednesday evening

Thursday morning

Thursday evening

Friday afternoon

I have provided only secure, personal contact information, where I am safe and willing to receive a reply.

Thanks for submitting! You will receive a confirmation email from info@wavecrest.us

©2018 by wavecrest. Proudly created with Wix.com

bottom of page