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Clinical Services Inquiry Form
Lindsay Swan
2021-04-27T12:35:15+00:00
Thank you for your interest in individual, couple, or family therapy with Nancy Knudsen, LMFT. Please fill out the form below to be added to a waiting list, receive a list of referrals, and/or discuss your therapy questions with Nancy. For questions, email
admin@coupleandfamilyinstitute.com
.
Name:
*
First
Last
Phone:
*
Email:
*
I'm looking for:
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Couples Therapy
Family Therapy
Please note: Nancy is no longer taking new clients for individual therapy.
For information about couple therapy intensives (1-day, 2-day or 2-day-plus) and to contact us for availability, please visit our
Couple Therapy Intensive page
.
Please describe any details you want us to know:
Please note that Nancy does not take insurance for couples therapy. For individual and family therapy, she accepts Blue Cross/Blue Shield, United Behavioral Health, Tufts, and Harvard Pilgrim. Her out-of-pocket rates are $175/hr for couples and family therapy, $150/hr for individual therapy, with some sliding scale fees available as needed.
I'd like to:
*
Be added to a waiting list
Receive a list of referrals
Discuss a few therapy questions with Nancy
Be contacted about an intensive
Nancy's work times are Monday-Thursday 12-7pm ET.
What days and times are generally open for you to receive therapy?
*
What days and times are good for you to have an initial conversation with Nancy?
*
What are your questions?
*
Additional questions/comments:
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