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Please complete the form below to be added to our waitlist. You will receive a welcome email when an appointment/provider becomes available.
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Type of Service Requested
You may select multiple options if that applies.
No Preference/First Available
Maritza Barrera, LMFT
Shamina Stagner, LMHC
Alyssa Schwegman, MA
Please note not all providers offer all service types. Please refer to the website to see each provider's specialty if needed.
Preferred Service Location
No preference/First Available
In person/In Office
How do you plan to pay for services
Reason for seeking services
Briefly describe why you are seeking services (ex. anxiety, trauma, relationship issues, etc).
How did you hear of us?
Please let us know if you were referred by a friend, your insurance provider, website, etc. Thank you!
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2454 N McMullen Booth Rd
Clearwater, FL 33759
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