contact me You can message me directly using the form below. Name * First Name Last Name Birthdate * MM DD YYYY Email * Phone * (###) ### #### Insurance * Please select your insurance carrier Aetna Anthem/Empire BCBS CDPHP Cigna Meritain MVP Health Care Optum Oscar Oxford United Health Care (UHC) United Medical Resources (UMR) Out of Pocket Other (if other please specify in message) Message * Are you seeking some type of documentation? * Note for a doctor, service animal, etc? no yes Preferred Session Type * Please select your preference from the pull down menu Virtual No Preference In Person Appointment Availability Monday 9 PM - 12 PM 1 PM - 4 PM After 4 PM Tuesday 9 AM - 12 PM 1 PM - 4 PM After 4 PM Wednesday 9 AM - 12 PM 1 PM - 4 PM After 4 PM Thursday 9 AM - 12 PM 1 PM - 4 PM After 4 PM Friday 9 AM - 12 PM 1 PM - 4 PM After 4 PM Thank you for your submission! All Fields Required karin@quetzalcounselingservices.com(315) 552-1787Syracuse, New York
