Lotus Counseling Services, PLLC Send Message

Who would be receiving care?

Your info

Select all that apply
Reason for care
Select any options that feel relevant to you. This helps us understand how to best support you. You may choose more than one.
We serve individuals aged 18 years and older. All appointment provided via telehealth.
Administrative
Enter how you were referred to our services
Do not upload sensitive financial information such as credit card information.
You can opt out at any time.
Billing & Payment
IF USING INSURANCE, we are unable to approve appointment requests without the front and back of your insurance card uploaded below.
Upload a photo of your insurance card
If you have more than one insurance policy, we will reach out to you via email to collect the additional information. It is important that you tell us if you have another policy, even if you do not plan to use it.
Client Preferences
Limited to 600 characters

If you or others are in immediate danger or experiencing a medical emergency, call 911 immediately.

By submitting this form, you agree to the processing of your sensitive personal information, which may include protected health information (PHI). This information may be viewed by team members in this practice.