Congratulations!
You've completed the first step to getting your
initial consult.
This form will ask you when and where you would like to get your assessment. Once you finish, we'll go find a few therapists that fit what your looking for and send you their profiles to review and choose from.  Once you pick one, then you can set up a quick 15 min call to see whether they're a fit.

(Filling out this form should take less than 5 minutes)
Get Started
 
Select a day to come in next week: *


 
What time are you available next week? *


 
Where would you prefer to see someone? *


 
Therapist Gender *


 
What would you like to talk to someone about? *


 
To make sure we match you with the right therapist, can you please click on the specific topics below that best describes what you want to discuss:


 
To make sure we match you with the right therapist, can you please click on the specific topics below that best describes what you want to discuss:


 
To make sure we match you with the right therapist, can you please click on the specific topics below that best describes what you want to discuss:


 
To make sure we match you with the right therapist, can you please click on the specific topics below that best describes what you want to discuss:


 
Who is this appointment for? *


 
Tell us a bit about yourself:

 
Your Name: *

 
What's the best number to call in case the appointment changes?

format:  111-111-1111
 
On a scale of 1-5 tell us how you're feeling






 
Tell us a bit more:

 
Your Name: *

 
Client #2 Name: *

 
Add more:

 
Tell us a bit more:

 
Client Name: *

 
Payment Method: *


 
Who is your health insurance with? *












 
Unfortunately, our SonderMind members are not accepting your insurance provider at this time. How would you like to proceed? *

We are sorry about the inconvenience, we hope to add your provider to our SonderMind network soon!

 
Please tell us more about your insurance information:

 
Policy number: *

 
Group number: *

 
Your Date of Birth: *

 
You will be charged {{var_price}} after each session. Enter your payment information below *

As per our cancellation policy, you may cancel your appointment without any fee up to 24 hours prior to your scheduled appointment. If you choose to cancel your appointment 24 hours prior to your scheduled time, all payments will be fully refunded.
 
Please enter your Credit or Debit Card number: *

 
The CVC number: *

(3 or 4 digit security number on the back of your card)
 
The name on your card: *

 
Your card's expiry month: *


 
Your card's expiry year: *


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Please type "Find a [your insurance] provider" into Google to find a professional to help
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Thank you! 
We will contact you within 24 hours
to confirm your appointment.
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Thank you!
We will contact you within 24 hours
to confirm your appointment.

If you're on an HSA or high
deductible plan you may be
responsible for the cost of the
appointment. Please contact
your insurance provider with
any questions.
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