Contact Wellspring Counseling To make an appointment or ask a question, fill out this confidential form and click on the "submit" button at the bottom. We will call you by phone as soon as possible, but no later than one business day after receiving your information. First Name * Last Name * Desired Appointment Days/Times Preferred Location RedmondDowntown SeattleRainier Avenue SSeattle (any location) Date of Birth (00/00/0000) Your Gender Your Phone # * Phone Type * Home Work Cell Is it okay to leave a voice message? * Yes No Email Address How did you find us? (optional) How are you planning to pay for therapy? Insurance Out of Pocket Wellspring EAP Other If using insurance, what is the name of your insurance carrier? If using your Wellspring EAP benefit, what is the name of your company? Is there a specific Wellspring therapist you'd like to see? If so, which therapist?