New Client Inquiry

Thank you for your interest in sessions with Stella Luna Counseling & Wellness – our goal is to serve you and to help you on the road to better mental, emotional and physical health! Please complete the form below, especially all fields marked as Required. Someone from our office will get in touch with you within one business day. You can also call us directly at 440-879-8517, or e-mail info@stellalunatherapy.com to set up a time to speak with us.

New Client Inquiry form

Name(Required)

First Last

Email(Required)

Phone(Required)

What type of counseling or wellness service are you seeking?(Required)

If you will use insurance, which insurance provider do you have? If you are not planning on utilizing insurance, please type N/A.(Required)

How did you find us?

Google

Facebook

Referral from family or a firend

Other

What days and times are you available for counseling or wellness sessions?(Required)

Which therapy or wellness services are you interested in?

I understand that Stella Luna may not accept my insurance at this time and that I will then pay out-of-pocket. I understand that therapy ranges between $100-$150 per session depending on the therapist I choose. We will let you know if your insurance is accepted in our network. We also offer super bills for those with out-of-network insurance benefits. I understand:(Required)

Yes

No

See our FAQs page for more answers on fees and insurance.

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Address

17951 Jefferson Park Road
Suite #100
Middleburg Heights, OH 44130

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New Client Inquiry

New Client Inquiry form

Address

(440) 879-8517