Preferred Name *

First Name

Last Name

Phone *

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Which therapy services are you interested in? *

General Individual Therapy

LGBTQ+ Affirming Therapy

Trauma/PTSD

Something else (please explain below)

Will you be using insurance? *

Please note: I currently accept Aetna, Cigna, and Blue Cross Blue Shield of Massachusetts. I am in the process of being credentialed with Anthem, United, Oscar, and Oxford, and can offer therapy on a sliding scale until I am fully credentialed (estimated Fall of 2024). I can offer a superbill for out-of-network services for potential reimbursement.

Yes, you are in-network with my insurance provider.

I will use an HSA card.

No, I will pay out of pocket.

Are you comfortable meeting virtually? *

Please note: I conduct all therapy sessions virtually at this time.

Yes

No

Preferred method of contact *

Please note: If you prefer email, all emails will come from jada@therapywithjada.com. Check your spam folder!

Text

Email

Phone