New client requestNew client requestPlease send your information by filling out the form below. My administrative assistant will contact you for further information and to discuss the next steps for scheduling an appointment. Please note, due to client and request volume it may be 3-5 business days before we respond. Thank you for your patience. Name First Last Last Email Is it ok to contact you via this email regarding scheduling therapy sessions? * Yes No Phone * Insurance * Blue Cross Blue Shield Blue Value/Blue Local Aetna United Health Care Cigna Medicare Other I do not plan to use insurance How did you hear about Grace? * Message Submit If you are human, leave this field blank.