Ready To Take the Next Step in Your Mental Health Journey?

Whether you're looking to schedule your first session or just have questions about working together, I’m here to support you. Please fill out the form with a few details, and I’ll be in touch within 24–48 business hours to discuss how we can move forward together.

Full Name*

Phone Number*

Email Address*

Preferred Method of Contact*

Phone

Best Time of Day to Contact You*

Morning (8am - 12pm)

Afternoon (12pm - 4pm)

Evening (4pm - 7pm)

Best Days of the Week to Reach You*

Monday

Tuesday

Wednesday

Thursday

Friday

Age Group of Client:*

What Brings You in Today?

ADHD

Anxiety

Depression

OCD

Postpartum Support

Trauma

Relationship/Family Issues

Life Transitions

Other

What Insurance Provider Do You Plan to Use?*

Aetna

Aetna - Medicare

Humana - Medicare

Humana Dual (Medicare & Medicaid)

United Healthcare/Optum

United Healthcare/Optu - Medicare

I Plan to Pay Out of Pocket/I Need Receipts for Reimbursement

Anything Else We Should Know?*

I understand that it may take 24–48 business hours to receive a response to my inquiry.

How To Reach Us

Phone

Email

Address

301-818-8100

andrea@careofselfcenter.com

9 North Court Street, Frederick, MD

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