Interested in becoming a client? Questions before you get started?

For more information on insurance and rates view our Insurance + FAQ page

6500 Glenridge Park Place, Suite 8
Louisville, Kentucky 40222

P: 502.303.2449

F: 502.384.7412

If you are interested in becoming a new client, please follow the prompts below to complete our intake paperwork. After submitting your forms, our office manager will contact you to match you with a provider based on your needs and schedule an appointment for you. Completing the intake paperwork does not establish a provider/client relationship. If you are experiencing a mental health emergency call 911 or go to your nearest emergency room. We do not schedule appointments prior to paperwork being completed. If you have any questions, please feel free to call/text us at 502-303-2449 or send us a contact form.

Name *Enter your full name

Email Address *

Phone *

In which service are you interested? *

Several of our counselors accept United (commercial plans only, no Medicaid, Medicare, or Tricare) We do not accept Anthem but accept HSA cards and can provide a receipt if you have out-of-network benefits. Search for providers who accept Anthem here: https://www.psychologytoday.com

Are you interested in: *

Are you pregnant or up to one year postpartum? *YesNo

Individual Counseling for Adults - Next Steps

Please click SUBMIT to begin your Individual Counseling Intake.

Couples Counseling - Next Steps

Please click SUBMIT to begin your Couples Counseling Intake.

Note: We do not bill any insurance plans for couples counseling.

Child Counseling - Next Steps

Please click SUBMIT to begin your Child Counseling Intake.

Our prescribers work with patients ages 6 and older. Is this appointment for someone ages 6-17 or 18 & older? *Between 6-1718 & Older

Briefly describe the concerns you would like to discuss with our provider.

Someone from our office will contact you soon to make sure our practice will be a great fit for you! Would you prefer a text, call, or email? *TextCallEmail

Parent Coaching - Next Steps

Christy Weber, founder of Bloom Counseling + Wellness Studio, is a certified Positive Discipline Parent Educator, parent coach, and mom of 3 young children. She is also a therapist with more than 12 years of experience working with women and families throughout her career as a Licensed Professional Clinical Counselor. She helps parents go from feeling overwhelmed and unsure to feeling calm and confident in their parenting.

Someone from our office will contact you soon. How would you like us to contact you? *TextCallEmail

Cell Phone

Please click SUBMIT to begin your Parent Coaching Intake.

Please do not fill in this field.

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6500 Glenridge Park Place, Suite 8
Louisville, Kentucky 40222

502-303-2449

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