New Client Inquiry Form - Greenlake Wellness Group

Hi there! To get matched with the best therapist for your needs, feel free to email us directly at scheduling@greenlakewellness.com. Or give us a call or text: 206-659-7161.

Compassion. Connection. Care.

We'd be honored to walk alongside you. Please share a little about yourself — this information helps us connect you with the therapist who’s the best fit. Everything you share is kept confidential.

What’s feel will

Patient Name *

Email *

Phone *

Preferred days/times for sessions *

Gender Identity *

Pronouns

Ex: She / Her He / Him They / Them

Do you have a therapist preference? *

What’s your preferred session format? *

In person at our Greenlake office (Seattle)
Online via telehealth
Either option work for me

What would you like support with? Please share as much detail as you feel comfortable — it will help us connect you with the therapist best suited to your needs. *

Payment Information

We’re in-network with Premera, Lifewise, and select out-of-state BCBS plans (not Regence). For sessions paid out of pocket, we can provide a superbill you can submit to your insurance for possible reimbursement.

How will you be paying? *

Greenlake Wellness Group

Compassion. Connection. Care.

Payment Information

Greenlake Wellness Group

Location

In-person or online with Telehealth

Call or Text for a Quick Response

(206) 659-7161