Book An Appointment To book an appointment, please fill out the form below: Name* First Last Email Address* Phone*Preferred Therapist*Preferred TherapistNo PreferenceBrittany Hardy, LMFTShaunda Jones, MS Clinical PsychKiana Green, LMSWCandace Williams, LMFTWould you like a free consultation?*Would you like a free consultation?YesNoPreferred Date and Time (1st preference)*Preferred Date and Time (2st preference)*Select Insurance*Select InsuranceCignaBCBS/AnthemUnited Health CareAetnaMagellanTricareSelf PayNot SureInsurance ID#*Date of Birth* Upload Insurance Cards* Drop files here or Upload Picture ID (for verification purposes)* Drop files here or How did you hear about us?*MessagePrivacy Consent* Yes, I want to submit this form. By submitting this form via this web portal, you acknowledge and accept the risks of communicating your health information via this unencrypted email and electronic messaging and wish to continue despite those risks. By clicking "Yes, I want to submit this form" you agree to hold The Hardy Clinic and TherapistRising harmless for unauthorized use, disclosure, or access of your protected health information sent via this electronic means.