Schedule an appointment

All submitted information is strictly confidential.

Providing your contact and insurance information helps us determine eligibility and scheduling
If you are uncertain about providing your information electronically, please contact us at 989.954.4673 to be screened over the phone

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Name *

First

Last

Date of Birth *

Phone Number *

May we text you at this number? *

Email *

Which Insurance provider do you have? *

Insurance ID/Member ID/Enrollee ID/Policy # *

What issues/symptoms are you experiencing? *

What are your currently available dates and times for appointments? *

Are you interested in services based at our Mount Pleasant or Traverse City location or virtual services? (if you prefer face to face but are open to virtual please pick that one) *

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* If you are not contacted within 2 business days a technical error may have occurred. Please call the office at 989-954-4673 to enquire.

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