Name *

First Name

Last Name

Payment for Session: *

Accepted Insurances LIsted Below

Not Using Insurance

Aetna

BCBS/Anthem

BCBS FEP

BCBS of National Capital Area

CareFirst

Cigna

United Healthcare/Optum

How did you FIRST hear about us? *

Psychology Today

Google Search

Google Ad

Facebook/Instagram post

Facebook/Instagram Ad

Insurance Website

Referral

Telehealth Services *

I am aware that Healing Hearts VA is an online/virtual private practice providing telehealth services only

If you answered "No", what prevented you from starting therapy before?

Your answers help with data collection

Self-sufficiency: Belief that I could handle issues on my own.

Cost: Therapy was too expensive.

Stigma: Concern about social stigma or judgment.

Awareness: Not aware of the benefits of therapy.

Availability: Difficulty finding a therapist or appointment times.

Motivation: Lack of motivation or belief in therapy.

Time: Not having enough time due to busy schedule.

Previous negative experience: Bad experience with therapy in the past.

Cultural beliefs: Cultural or family beliefs discouraged therapy.

Privacy concerns: Worried about confidentiality or privacy.

Struggles only began recently