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INDIVIDUAL AND GROUP THERAPY SERVICES BY THE CBT/DBT CENTER

Schedule a 15-minute free consultation appointment to find your best-fit therapist.

NOTE: The completion of this form does not constitute a client/therapist relationship, which will only be established after an initial intake and signed consent.

First name*

Last name*

Phone*

Email*

What is the purpose of your inquiry?*

Scheduling a new therapy consultation

Question about courses/groups

General question about services

Referral for a client

Other (Please specify below)

Are you looking for individual therapy, group therapy, or unsure?*

Individual therapy

Group therapy

Unsure

N/A

For whom is this inquiry?*

For myself

For my child (please specify age)

For a family member (please specify relationship)

For a client (if you are a provider)

Do you plan to use insurance for therapy?*

I prefer to use my in-network insurance only

I will pay privately and seek out-of-network reimbursement

I’m open to options and not sure yet

I do not plan to use insurance

How did you hear about The CBT/DBT Center?*

Referral Org

Therapist

Friend/Family

Website/Whatsapp/Email Newsletter

Other

Please share any additional information that will help us understand your needs:

Our session fees start at $100 and we have available limited sliding scale sessions. We are an out-of-network practice and do not accept insurance directly. We work with all insurance companies as an out-of-network provider and recommend that all clients reach out to their insurance company to find out if they are eligible for any coverage.

We currently offer in-person sessions in Queens, NY and Jerusalem, Israel, as well as virtual sessions for those in eligible locations.