Connecting Pazos
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About Us
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FAQs
You deserve love that just
feels
right
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New Patient Intake Form
First name
Last name
Email
Phone number
What type of therapy are you looking for?
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Individual
Couples
Method preferred for sessions
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Virtual
In person
Preferred meeting time
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Morning
Afternoon
Evening
Are either or both of you in individual therapy?
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We both are
We both are not
I am, my partner is not
I am not, my partner is
What insurance do you have?
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Aetna
Blue Cross Blue Shield
Oscar
Oxford
Quest Behavioral Health
United Healthcare
Other
Optum
No insurance
Please enter you current insurance provider
Briefly explain what brings you here
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