EMDR Contact Form - Three Oaks Behavioral Health & Wellness

Name *

First

Last

Pronouns

Age/Date of Birth *

Email *

Phone Number *

Preferred Contact Method

How would you like us to get in touch with you?

Preferred Office Location *

What is your preferred office location? Based on the specialties & availability of our clinical team, we will do our best to link you with a therapist at the office site you prefer.

Office Location(s): Secondary Preferences

Please list all other offices you're open to visiting.

Scheduling

Based on the availability of our clinical team, we will do our best to link you with a therapist who has openings during your preferred schedule. We will be better able to connect you with your preferred therapist if there is flexibility within your calendar preferences.

How soon would you like to meet for your 1st session? *

We will make every effort to connect you with a therapist as soon as possible. When determining the best fit between therapist and client, we consider many aspects, including appointment availability, office location, client preferences, therapeutic specialties, etc. Please note: Three Oaks does NOT offer immediate appointments or emergency services. If you are experiencing a mental health crisis or have suicidal thoughts, please call 911 or reference our emergency resources.

Insurance *

We do NOT currently accept Blue Home, Blue Value, United, Medicaid or Medicare. We are in-network with BCBS (PPO plans), Evernorth (formerly Cigna), & Aetna. We also accept the NC State Health Plan and EAPs. Additionally, we are able to bill out-of-network with other major insurance companies. Please visit our FAQ page to learn more about billing & insurance.

Have you been in therapy before? *

Have you participated in EMDR therapy before? *

Message

Please describe what events you would like to work on with EMDR that you know about now, and what symptoms you are currently aware of, as well as any current or existing diagnosis or medical concerns