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 (Care First, Horizon, Anthem, etc.)

Mental Health Consultants

I Will Pay Privately

Please select at least one option.

We are in-network with Independence and most Blue Cross PPO plans, as well as Mental Health Consultants (MHC). If you have a different plan, we're happy to see you as an out-of-network client with a superbill for reimbursement.

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 therapeutic specialties are you looking for? (optional)

Scheduling

When are you available?

Let us know which days and times generally work for you so we can find a therapist whose schedule fits. Please note that evening appointments are in high demand and may take longer to schedule.

What days and times are you available for sessions? *

Please let us know when you're available.

Let's find you the right fit.