Request an Appointment

We are excited for our future together

Any client 18 years or older needs to complete their intake forms in order for us to accept them. Please only complete one intake form per client. Thank you for choosing Think Happy Live Healthy.

*Please note: We currently do not accept clients under the age of 5 for therapy services.

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Request an Appointment

Client Full Name

Name of person completing this form

Your relationship to client

Client's Age

Cell Phone #

Current City & State You Reside

Email Address

What insurance do you have? We are only in-network with most Carefirst and Anthem plans.

Main reason for seeking therapy

Please provide any relevant details regarding why you are currently seeking therapy

Choose which services you are interested in. * Required

Individual Therapy

Psychiatry

Psychological Testing (up to age 21)

Short Term Solutions

EMDR

Parent/Child Consultation (insurance not accepted)

Adult Consultation (insurance not accepted)

Brainspotting

What is your weekday availability for ongoing therapy sessions? Requests for evening appointments will result in longer wait times. * Required

Weekday 9AM-3PM

Weekday 3PM-5PM

Weekday 5PM-8PM

9-5 Weekends (limited)

Are you interested in telehealth sessions, in-person sessions, or both OK? In-person will genally result in longer wait times than telehealth.

Today's Date

Thanks for submitting! Please be on the lookout for an email from info@thinkhappylivehealthy.com within 24 hours. Please feel free to follow up with an email.

256 N. Washington St., Suite 2
Falls Church, VA 22046

20955 Professional Plaza
Suite 310/320
Ashburn, VA 20147

703-942-9745

info@thinkhappylivehealthy.com

Think Happy Live Healthy — Full‑Spectrum Mental Wellness in Northern VA

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