If this is a mental health emergency, please click here. To access the Grow Well Cleveland client portal - please click here. To schedule an appointment please contact our scheduling specialist or fill out the form below. Scheduling Specialists Becky Currier Becky@growwellcle.com (216) 200-8125 Sandy Chalkwater Sandy@growwellcle.com (216) 223-8773 Please note: ALL Grow Well Cleveland clinicians are seeing via TeleHealth ONLY Client's Full Name: Client's Date of Birth (mm/dd/yy): Parent/Guardian Name (for 18 and under): Address: City: State: Zip Code: Email: Home Phone Number: Cell Phone Number: Gender: Personal Pronouns: Preferred Name: Please specify preferred appointment days: SundayMondayTuesdayWednesdayThursdayFridaySaturday Please specify preferred appointment times: Morning (8AM-Noon)Afternoon (Noon-4PM)Evening (4PM-8PM)Anytime Preferred Office Location: TeleHealthOhio City Office (3000 Bridge Ave. Suite 4) - CURRENTLY UNAVAILABLELakewood Office (1662 Mars Ave.) - CURRENTLY UNAVAILABLE Please specify what type of counseling you are seeking: Individual CounselingCouples/Marriage Counseling Please select if you are willing to work with an emerging practitioner (an intern): YesNo Please select if you are comfortable with an emerging practitioner (an intern) observing your session: YesNo Have you ever been treated for any mental illness? Such as by a psychiatrist, general practitioner, or other counselor/therapist: YesNo Have you been recently hospitalized for a psychiatric issue?: YesNo Are you currently experiencing suicidal thoughts or have had any in the past 6 months?: YesNo Have you ever attempted suicide? If yes, how long ago was this? If yes, have you attempted more than once?: Are you currently experiencing thoughts or urges to harm yourself or others? Have you had thoughts or urges in the past 6 months?: YesNo Are you an Ohio resident/physically in the state of Ohio during appointments?: YesNo Preferred Therapist: Please choose a preferred therapist NOTE: All therapists are seeing clients via Telehealth ONLY Group Only Pete Finnerty Jessica Sen Holly Hengartner Michael Pennington Ally McCarley Molly Martin April Elsasser Morrondo Roberts Nick Chmura Erik Ribera Emily Pohorence Jacob Irey Carolyn Allen Theo Eiben Brian Moser Allison Borstad Olivia Campbell DeQuan Brown (intern) Kim Hurlburt (intern) Matt Plauny Cassie Kingan Julie Lineburgh Douglas Davis (intern) Stacey Sinwald Kristy Mitchell Rachel Astorino (intern) Trisha Zivkovic (intern) Alternate Therapist: Please choose a preferred therapist NOTE: All therapists are seeing clients via Telehealth ONLY Group Only Pete Finnerty Jessica Sen Holly Hengartner Michael Pennington Ally McCarley Molly Martin April Elsasser Morrondo Roberts Nick Chmura Erik Ribera Emily Pohorence Jacob Irey Carolyn Allen Theo Eiben Brian Moser Allison Borstad Olivia Campbell DeQuan Brown (intern) Kim Hurlburt (intern) Matt Plauny Cassie Kingan Julie Lineburgh Douglas Davis (intern) Stacey Sinwald Kristy Mitchell Rachel Astorino (intern) Trisha Zivkovic (intern) Primary Insurance: Please choose an insurance provider N/A - Self-pay Caresource Beacon Medical Mutual Mutual Health Medicaid Medicare United Healthcare Behavioral Health Molina Aetna UMR Humana Military/Tricare Humana OSCAR Paramount Buckeye SummaCare Cigna Anthem/BCBS