Welcome to Spirited by Truth This pre-intake form will help ensure that you are in the right place to begin your healing journey. Before submitting this form, please be sure to review our website to see the select range of counseling services we provide. Paying For Your Counseling Sessions

• We ARE NOT accepting most health insurance plans at this time.
• Aetna and Network Health: We currently have limited spaces available to Aetna and Network Health client. When we reach our maximum number of clients under these plans, you CAN NOT pay out of pocket and we will not be able to provide services to you.
• Self-Pay Clients: Self-paying clients (also known as private pay or out-of-pocket), first review our investment page at spritedbytruth.com/investment before submitting this form. DO NOT submit this form, if you aren't able and ready to make the investment.

Disclaimer: California law prohibits that you must be 18 years of age or older to complete this form. If you are under the age of 18 years old, do NOT continue. This website is not monitored 24/7. Your form will be reviewed within 24-72 business hours. Submitting this form is NOT an agreement or start to services. Instructions: To complete the form, please read and answer each question honestly and open-heartedly to the best of your knowledge. Before you begin, are you completing this form for yourself or someone else? (If you are not over 18 years old, do not continue. No exceptions.) *