New Client Request Form

NEW CLIENT APPOINTMENT REQUEST

In response to COVID-19, All appointments are currently virtual. Sarah is licensed and able to see clients in WA and OR state. Please click here to read some FAQs about Virtual Sessions with Sarah.

* Indicates required field

Name *

First

Last

Gender identity: *

Phone Number *

Email *

Insurance Plan *

Referred by *

Please select any healthcare providers you currently see *

Other provider: *

What is your biggest challenge in your relationship with food? *

What would you like your relationship with food to be like 6 months from now? *

What are your goals for your work with me? *

Thank you!

Submit

Insurance Coverage

Most major insurance plans are accepted. If your insurance plan is not accepted, Sarah can provide you with a superbill that you can submit to your insurance company for reimbursement purposes. Please use this insurance script to help you identify how your insurance plan will cover nutrition counseling with Flourish.

Accepted Plans:

Kaiser
Premera
Regence
Lifewise
HMA
Aetna
Cigna
First Choice

​NEW CLIENT APPOINTMENT REQUEST

Insurance Coverage

Accepted Plans:

NEW CLIENT APPOINTMENT REQUEST