About You

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Telling us more about you helps us serve you better

Please Answer the following Questions to better help us assist you. your feedback is important to us!

* Indicates required field

Age *

18-29 30-39 40-49 50-59 60+

Gender *

Male Female

How did you hear about us? *

Insurance Plan Friend/Family/Colleague Community Event Website Google Social Media Print Media

Employment *

Unemployed Part-time Full-time Student Self-employed Retired

Education *

Some High School Completed High School Some College Associate's Degree Bachelor's Degree Master's Degree Doctorate

Ethnicity *

African Descent Asian Caucasian Hispanic Native American Other

In which area do you live? *

Please identify the insurance company you plan to use or if you are using the ‘fee-for-service’ option. *

What services are you inquiring about? *

Stress, Anxiety, Trauma Ultimate Healing Package Work-Life Balance Career Counseling Test-Taking Anxiety Detoxification for Addictions Speaker

Check all that apply.

What would you like to do? *

Schedule Free Consultation Schedule My Appointment

Consultations are up to 30 minutes.

First and Last Name *

Please share your name with us so that we may address you upon contact. Your information is always confidential.

Email Address *

Phone Number *

Please share any additional information or comments regarding your inquiry. *

I agree to receiving marketing and promotional materials *

Submit

Thank you for visiting Illuminated Paradigm Counseling & Healing, LLC

Illuminated Paradigm Counseling & Healing, LLC does not complete or provide FMLA paperwork. IPCH recommends that you receive all necessary documentation, forms, and paperwork from your primary care physician and or your medication monitoring provider. IPCH will assist clients by providing letters of support informing necessary parties that an active client is currently receiving mental health services.

Hours

Mon - Fri | 8:30 a.m. - 6:30 p.m.

Location:
Teletherapy
10989 Red Run Blvd, Suite 202, Owings Mills, MD 21117

Email

[email protected]

Telephone

(443) 738-4724

Home
The Ultimate Healing Package
STORE
Contact IPCH
- IPCH Vantage Point (BLOG)
- Questionnaire