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Schedule an appointment for in-person with our Minnesota Clinician

Let’s Match You With the Right Clinician

Your answers will help us recommend the right care for you.

Emails received evenings/weekends are returned the next business day.

Name *

First

Last

Preferred Name (if different than Legal name)

Preferred Contact Method:

Phone
Email

Phone

Email

Date Of Birth *

What types of services are you looking for:

Therapy for Myself
Couples Counseling
Family Therapy
Medication
Intensive Therapy / Deep Dive Program
Therapy for Someone Else

Who will be attending?

Adults
Teens
Children (under 12)

Name(s) and Date(s) of Birth (optional)

Therapy for Myself

ADHD
Anxiety
Depression
Past Trauma
Grief and Loss
Addictions
EMDR Therapy
Relationship Issues
Something Else

Partner’s First Name

Partner’s Date of Birth

Couples Counseling

Communication Issues
Considering Break Up or Divorce
Conflict
Infidelity
Parenting Issues
Pre-Marital Therapy
Sex & Intimacy
Trauma Recovery
Something Else

What is the Primary Insurance (We do not accept Secondary Insurance or EAP programs) *

Aetna
Anthem/Blue Cross Blue Shield
Cigna
Health Partners
Optum
Medica
United Healthcare
UMR
Some Other Insurance
I Prefer to not use Insurance (most confidential option)

Do You Prefer…

In-Person Sessions
Virtual Sessions
No Preference
Not Sure

Will you be located in Minnesota at the time of the appointment?

Yes
No

In-Person Sessions

Edina Location
Golden Valley Location
Either

Are you reaching out for counseling following an accident or injury (car accident, dog bite, slip and fall, etc.)?

Yes
No

Is there a Specific Clinician You Want to Work With?

Tell us what's going on so we can make a recommendation:

Is there anything else you want us to know? (e.g. You cannot do daytime appts, You prefer a Female Therapist, You need someone with a specific specialty, etc.)

Would you like us to send you FREE Resources, Articles, Guided Meditations, and Tips in a Monthly Newsletter?

Yes, Please!
No Thanks

MAILING ADDRESS

7505 Metro Blvd. Suite 505 Edina, MN 55439

EMAIL

[email protected]

CALL US

651-271-1665

FAX

612.999.1767

ALL IN Therapy Clinic - Golden Valley, MN Office

7500 Olson Mem Hwy #300, Golden Valley, MN 55427, United States

651-271-1665

ALL IN Therapy Clinic - Edina, MN Office

7505 Metro Blvd Suite 505, Edina, MN 55439

651-271-1665

MAILING ADDRESS

7505 Metro Blvd. Suite 505 Edina, MN 55439

EMAIL

[email protected]

CALL US

651-271-1665

FAX

612.999.1767

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