Intake FormCCCadmin2022-05-23T16:00:43+00:00 Intake Form Please enable JavaScript in your browser to complete this form.Name *FirstLastEmail *Phone Number *Location of Choice *Wexford (with optional Telehealth appointments)Squirrel Hill (with optional Telehealth appointments)Counselor of Choice in Squirrel Hill *Catia Fath, NCC, LPCJennifer Black, LPC Jennifer Matesa, LCSW, MFAKatyana Gradler, LCSWHayley Sweitzer, LCSWAllyse Rindone, LPCKelly Horvath, MSWDirector's recommendationIf no choice is made, the director will make a recommendation.Counselor of Choice in Wexford *Catia Fath, NCC, LPCNicole Metger, LPCJessica Peluso, LPCDirector's RecommendationIf no choice is made, director will make a recommendation.Briefly describe why you are seeking help. *Insurance (We do not accept Medicare or Medicaid.) *AetnaBlue Cross/Blue ShieldEvernorth (Cigna)HighmarkUnited HealthcareUPMC CommercialOtherSelf PayMessageSubmit More Questions? Call (412) 259-5077 Email Creating Connections Counseling
