Tranquil Waters Foundation Inc.

Psychology, Mental Health, Life

Client Forms

If you are new, please feel free to fill out these intake forms before our first session. These forms can also be filled out during the first session.

If you feel that you would like to collaborate your session with another provider, simply fill out the following form.

Authorization for Release of Information

Reach out to us

First Name *

Last Name *

Phone *

Email *

Message *

Preferred Date & Time *

Currently Accepting the following Insurance Plans and Self Pay Rate: Aetna, Ambetter, Blue Cross Blue Shield Plans, Cigna, Self Pay $175, Medicare,

United Healthcare, Oscar Health, Oxford, Optum.

To get started, you can complete this link:

https://link.premiervantage.net/widget/form/X9xopmrkZMv8yIuVAOs1

Thanks and looking forward to starting your therapeutic journey with you!

Get In Touch

Need to reach us? Shoot us and email or give us a call today.

Email: [email protected]

Phone: 4077389408

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