Schedule Now Is this scheduling request for a child under 18 years of age or for a family?*YesNoImportant!!! Unfortunately, our office is no longer providing adult therapy services. We will continue seeing children, adolescents and families as well as providing parenting classes. If you need adult, mental health, or substance abuse services, please go here.Name* First Last Phone*Email Date of Birth* Date Format: MM slash DD slash YYYY Preferred Time(s) of Day Morning (8-10) Midday (11-1) Afternoon (2-4) Evening (5-7) Preferred Day(s) of the week Monday Tuesday Wednesday Thursday Services Requested Individual Therapy Group Therapy Family Therapy Co-Parenting Program Preferred Therapist No Preference C.J. Quick, LPCC-S, LMFT, RPT-S Beth Larimore, LPCC-S Sarah Reynolds, LCSW Chris Longoria, LCSW, RPT Krista Mitchell, CSW Type of Insurance/Payer Anthem Blue Cross/Blue Shield Passport Humana CareSource Aetna Better Health of KY Wellcare of KY Aetna Humana United Health Care/UBH/UMR Cigna GEHA Tricare Medicaid Other Any additional Requests or Information you'd like us to know...