Availability & New Client Call

**To streamline the onboarding process please read through this information before contacting us.**
Please use the form below or call us at (541) 719-8544 to share:
Your contact information
One goal for therapy
Your insurance details. Go to the **Billing & Services** tab for more information on what to include about your insurance.
We will contact you to schedule a new client call. For the phone call be prepared to discuss insurance, scheduling, and what you are looking for in therapy.
When providers don’t have availability you will still be contacted and your name will be added to a rolling waitlist.

Contact Form

Name

First Name

Last Name

Email

Phone

(###)

###

####

New Client Inquiries

Questions & Other Information

By submitting this form via this web portal, you acknowledge and accept the risks of communicating your health information via this electronic messaging and wish to continue despite those risks. By clicking "Yes, I want to submit this form" you agree to hold The Roost Counseling harmless for unauthorized use, disclosure, or access of your protected health information sent via this electronic means.

Yes, I want to submit this form & agree to the terms of use.

Availability & New Client Call

Contact Form