Let’s connect! Reach out to get started today. Name * First Name Last Name Email * Phone * (###) ### #### Name you go by, pronouns * How is grief or loss affecting your life now? * How did you hear about Anna and Skylight Wellness Center? * What type of therapy are you interested in? * In-Office Therapy Virtual Therapy Walk and Talk Therapy (not eligible for insurance reimbursement) In which state will you be physically located at the time of your therapy sessions? * Pennsylvania Massachusetts How do you intend to pay for therapy? * I intend to pay out of pocket. Full fee due at time of service; rates as of 7/05/2024 are $200 for a 75+ minute intake session and $175 for a 50+ minute ongoing therapy session. I intend to use my out-of-network health insurance benefits (if eligible). I will pay the full fee and submit a receipt to my insurance company for partial reimbursement. I intend to use my in-network health insurance benefits. Eligible Insurance Plans If you intend to use your insurance to pay for therapy, what type of insurance do you have? Most commercial Aetna and Optum/UnitedHealthcare insurance plans are accepted as of 1/01/2024. Please confirm your payment responsibility with your insurance company before our consultation. Non-Eligible Insurance Plans I understand that Medicare and Medicaid plans (including MassHealth) are not accepted. If I have a Medicaid or Medicare plan, I will not be able to use my insurance to pay for therapy. I understand. I'm not sure whether I have a Medicaid or Medicare plan. Are you a student? * Yes No In-Office Therapy available at 2929 Arch St, Ste 1700, Philadelphia, PA 19104