Brewer Therapy & Associates

If this is an emergency, call:

Client Information

First name

Last name

Phone number

Email address

Age

Day of the Week

Mondays- 5:30

Tuesdays- 5:30

Wednesdays- 5:00

Thursdays- 5:30

Saturdays- 11:00

Saturdays-12:15

Saturdays-1:30

Saturdays-2:45

Career Field/Occupation

What challenges are you currently facing regarding your mental health?

If there's anything else that you would like me to know prior to your appointment, please include it here.

Date of Birth

Insurance Member ID Number

Front of Insurance Card *We are not in network with Federal Blue Cross Blue Shield

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