Request an Intake Appointment

Emergency Assistance

If this is an emergency, call:

911
Beaver County Crisis Line: (724) 731-8060
Butler County Crisis Line: (800) 295-3866
Lawrence County Crisis Line: (724) 652-9000
Mercer County Crisis Line (724) 662-2227

Client Information

First name

Last name

Contact Person Name

Please list if contact person is not client, ie, parent or care taker

Client Date of Birth

Email address

Phone number

Home Address

City/ State/ Zip

Preferred Contact Method and Times: Please note that our administrative staff works between 10:00 AM - 3:00 PM M-F and is unable to make calls outside of those times.

Please indicate how you would prefer for us to contact you. If you request to have your intake set up via email you will need to be sent and complete our credit card form prior to being able to confirm a scheduled appointment. We CANNOT schedule intakes via text messaging as it is not a secure form of communication. Emails will come as encrypted from admin@angelus.hush.com. If you are expecting a response via email please check your spam/junk folder as at times these can be funnelled there by your email provider.

I'm a previous client

Is it ok for Angelus to leave a voicemail at contact number?

Would you like added to our email list for practice updates and our monthly newsletter to learn more about community resources, mental health awareness and our services and clinicians?

Insurance & Payment

Insurance Member ID Number

Plan Carrier Information:

If your insurance is carried by anyone other than you, please list their first and last name, birthday, phone and address. This information is required by the insurance company as verification and not for us to reach out to that person.

Secondary Insurances

Please list any secondary or tertiary insurance information you may have

Health Insurance Card Upload Please upload a copy of your medical insurance card (or cards if you have secondary insurance). This will allow us to give you more accurate benefits information prior to your first appointment.

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Angelus Insurance Network Statuses

Insurance can be complicated. This chart may help you explore which therapists may be in and out of your insurance network.

Let us know if you have certain days or times you need to schedule your appointments within. Check all that apply and we will try our best to accommodate. Some slots are in higher demand and can take longer to schedule for.

Mondays

Tuesdays

Wednesdays

Thursdays

Fridays

Saturdays

Mornings

Afternoons

Evenings

In which office would you like to be seen? Check those most convenient for you, please keep in mind that there are variations of which therapists are at each location and which insurances are able to be accepted. Please reference our locations page on our website for more in detail information on each.

143 E Wallace Ave, New Castle, PA 16101

*COVID precautions, such as mask wearing, are mandatory for in person counseling sessions.

2370 N Hermitage Rd, Hermitage, PA 16148

*COVID precautions, such as mask wearing, are mandatory for in person counseling sessions.

Laurel Elementary School- 223 McCaslin Rd, New Castle, PA 16101

Compass Program- Lori Krol, LPC - Only able to see registered students of Laurel School district

Laurel Jr Senior High School- 2497 Harlansburg Rd, New Castle, PA 16101

Compass Program- Lori Krol, LPC - Only able to see registered students of Laurel School district

Virtual- Online Video Based Counseling

Counseling sessions available from the comfort of your own home. Due to licensing regulations, all clients must be physically in the state of Pennsylvania during your entire appt time.

About Your Appointment

Photo ID Upload Required - Driver's license or state ID only. No Selfies please If you are requesting services for a minor please upload a copy of either the minor's student ID or your driver's license/ photo ID. We are required to have an ID on file as proof identity for sessions/ insurance usage.

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Additional Information for Therapist:

Please let us know any presenting issues, concerns, or areas you would like to work on in counseling so that we can match you with the best therapist to meet your needs.

How did you find our website/office today?

Please let us know how you found our office, were you referred by someone, see us on social media or find us through a google search? This will help us with coordinating your care

Files

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Your information will be encrypted.

Angelus Therapeutic Services Inc

Angelus has been in practice since 2009 and consists of a group of skilled therapists whose specialties vary in focus and populations treated. The clearer you are regarding your reason for starting counseling the better we can match you to your ideal therapist. Our intake coordinator, Melisa, is available Monday - Friday from 11 AM -3 PM to answer any questions or concerns you may have and to assist you in scheduling your intake.