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Home
About Nate
Frequently Asked Questions
Testimonials
Fees & Payment
New Client Forms
>
Client Referral Form
Counseling Services
Couples Counseling
Individual Therapy
Family Therapy
Teletherapy
Workshops
Resources & Helpful Links
Areas of Specialty
Contact
Location
New Client Inquiry Form (does not guarantee services)
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Indicates required field
Name
*
First
Last
Birthdate
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Parent or Guardian Name (if under 18 yrs old)
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First
Last
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Address
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City
State
Zip Code
Country
Phone Number
*
Email
*
Health Insurance (please note, health insurance may not pay for services)
*
I prefer not to use insurance
Couples/Marital Counseling
Blue Cross Blue Shield (plans other then State Health Plan)
Blue Cross Blue Shield NC State Health Plan
Cigna
Aetna
Beacon Health Options
United/UMR
chose one
Insurance Policy ID Number:
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What are the best days/times for appointments?
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Please enter at least two options.
Preference for Service
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Video (Telehealth)
In Person Office Visit
please select one
Reason for Contacting Nate Sawyer Counseling:
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How did you find Nate Sawyer Counseling?
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