APPOINTMENT REQUEST

This form allows you to request a booking with one of our Wellness Grove clinicians.

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Full Name *

Email Address *

Phone Number *

Area of Counseling
— Choose Area of Counseling —AbuseAcademic ProblemsAdjustment and Life TransitionsAdolescent IssuesAging & Geriatric IssuesAnger ManagementAnxietyBlended FamilyBody ImageBoys' & Men's IssuesBullyingBurnoutCareer DevelopmentCaregiving IssuesChildhood TraumaChildren's IssuesChronic Health Issues & DisabilityChronic PainCommunication & Conflict ResolutionCoping SkillsDepressionDivorceEating DisordersFamily ConflictFirst Responder IssuesGender DysphoriaGirls' & Women’s IssuesGratitudeGrief & LossIntimate Partner ViolenceLGBTQ+ IssuesMarital, Pre-marital, & CouplesMeaning & Purpose in LifeMilitary IssuesMulticultural ConcernsOTHERPandemic CounselingPanic AttacksParentingPerfectionismPregnancy & PostpartumRelationship IssuesSelf-CriticismSelf-esteemSelf-harmSomatizationSpiritualityStrengthsStressSubstance Use IssuesSuicidal IdeationTrauma & PTSDWellness

Clinician
— Choose Clinician —Dr. Jessica Headley, LPCC-S, PMH-CDr. Christina Woloch, LPC, LICDC, C-DBTAndrew B Allen, LPCC-SKellie Feciuch, LPCC-SMelissa Hladek, LPCC-S, ATR-BC, PMH-C, C-DBTRichard Stein, LPCC-S, LICDC, CSAM, CCATP, CTMHMatthew Campbell, LPCC-S, LICDC, NCCRachel Gombash, LPCCKelsey Armentrout, LPCC, ATRMaria Hardgrove, LISWPaige Wallace, LPCCCynthia Cox, LPCCCrystal Snyder, LPC, LICDCErin Black, LPCCianna Dorando, LPCChristy Ward, LPCShayna Mell, LPCCarly Chapman, LPC, ATRSusanna Campbell, LPCBrian Keith Starcher, LPCChelsea Martinez, LPCLindsay West, LPC, CDCAMegan Hannum, LPCKevin Smith, LSWNatalie Cross-Ketler, LPCMi'Kael White-Davis, LPCLeah Blankenship, LPCMarlon Walker, LSWUrsula Messina, CTMadison Blyer, CTSarah Morris, CTAubrey Dempsey, CTMaggie Wilson, CTMegan Smead, CTJessica Burge, CTMegan Fortney, CTChristina Smith, CT

Preferred Day
— Choose Preferred Day —No PreferenceMondayTuesdayWednesdayThursdayFridaySaturday

Preferred Time of Day
— Choose Preferred Time of Day —No PreferenceMorning (open to 12pm)Afternoon (12pm to 5pm)Evening (5pm to close)

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