Get Started | New Client Inquiry | Radiance Therapy Group

Getting started

Who is this inquiry for?

Are you filling this form out for yourself or someone else? *

Myself

My Child

Please select an option.

Tell us about you

Just the basics

So we know how to reach you and start the process of getting you connected with care.

First Name *

Last Name *

Preferred Pronouns (optional)

Date of Birth of Client *

Email *

Phone (optional)

Preferred Method of Contact *

Phone

Email

Text

What type of health insurance plan do you have? (check all that apply)

Independence Personal Choice

Independence Keystone Health Plan East

Independence Administrators

Amerihealth

Other Blue Cross or Blue Shield PPO Plan (Horizon, Anthem, etc.)

Mental Health Consultants

Finding the right fit

What are you looking for?

The relationship you have with your therapist matters. These questions help us understand what you're looking for, so we can make a thoughtful match that feels safe, supportive, and right for you.

Type of Service *

Preferred Therapist (optional)

Another Therapist You're Interested In (optional)

Would you prefer in-person or virtual sessions? *

In-Person (Rittenhouse Square)

Virtual

Open to Either

Please select an option.

What are you hoping to get out of therapy? (optional)

Scheduling

When are you available?

Check all that apply so we can find a therapist whose schedule works for you.

Let's find you the right fit.