Art Therapy/Substance Use Please enable JavaScript in your browser to complete this form.Client Name *FirstLastIs client under 18 years old? *YesNoRelationship to Client *Parent/GuardianSelfParent/Guardian Name *FirstLastEmail * Phone *Payment Method *Self PayInsuranceWould you like to opt in to text message? *YesNoBy opting in, you consent to receive text messages regarding appointment scheduling, including reminders, cancellations, and updates. These messages may also include information related to copays, insurance, and other billing matters.Submit