Freely Living OCD and Anxiety Therapy, LLC

Freely Living OCD and Anxiety Therapy, LLC Send Message

Who would be receiving care?

Someone else

Your info

First name

Last name

Phone

Name you go by

Date of birth

Gender

State

Select the state you live in

Reason for care

Please describe the primary reason for seeking care at this time. Please note that Dr. Hoffman specializes in OCD and anxiety disorders for ages 6-17 and offers specific phobia treatment (including fear of vomiting) for all ages.

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Who do you want to attend appointments?

Child Child + Parents Parents only Not sure

Note:

Dr. Hoffman will not be a good fit for those experiencing active suicidal ideation or substance use unless separate treatment also in place.

Administrative

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Referral source

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Billing & Payment

Payment method

How do you plan to pay? (Dr. Hoffman is not in-network with insurance; Initial Intake $225, Standard Appointments (45-55 minutes) $200)

Client Preferences

Preferred appointment times

9 10 11 1 2 Monday Tuesday Wednesday Thursday

Preferred modality

Is there anything that the practitioner needs to know?

For example: what you'd like to focus on, insurance or payment questions, etc.

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For medical emergencies, contact your healthcare provider or call 911. For mental health crises, call or text 988.

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. You also agree not to submit any payment information, including credit or debit card details, through this form.