Request An Appointment Intake form Our intake coordinator will be in contact with you soon. Name PhoneEmail When are you available for an intake phone call? Morning (9AM-12PM) Afternoon (12PM-3PM) Evening (3PM-5PM) Who are you seeking counseling for at this time? Self, adult over 18 years old Child, minor under 18 years old Couples, marriage counseling Child's Name Child's ageWhat issues are you hoping to address in counseling? Availability for Counseling Appointments Morning (8AM - 11AM) Afternoon (12PM - 3PM) Evening (4PM - 7PM) Aetna insurance is accepted by Lydia and offered via Telehealth only on Wednesdays. Are you looking to use Aetna Insurance?YesNoPreference for CounselorLydiaEmilyRachelAlexNo PreferencePlease read all about our counselors on our About page.How did you hear about us? PhoneThis field is for validation purposes and should be left unchanged. 81898Δ Contact Us If You Have Questions Contact Us