Connect With Me Are you ready to activate your drip? Fill out this form to get started! Name * Potential client name First Name Last Name Phone * Best contact for you (###) ### #### Email * Best email for you to be contacted What Are You Willing To Invest In Your Healing Process? * What is your ideal budget PER therapy sessions. What is your ideal budget PER therapy sessions. $100 or less No More than $150 up to $200 Whatever it takes to heals! Do you have Insurance? * If you have insurance, who? Select Insurance Provider Aetna UHC/UMR/Optum BlueCross BlueShield Cigna/Baylor Scott & White Other Self-Pay / No Insurance Ideal Availability for Sessions? * When can you most likely attend your sessions. What Brings You In: * Briefly share what brings in into therapy. How did you hear about Trelle The Therapist? * Facebook Instagram Therapy For Black Girls Client Referral Therapist Referral Google Other Thank you!
