Wildness-Inspired Liberating Discovery

Wildness-Inspired Liberating DiscoveryWildness-Inspired Liberating DiscoveryWildness-Inspired Liberating Discovery

Contact Us

Reach out to connect!

First & Last Name*

Email*

Phone*

Source of Funding*

If Medicaid, please provide the following: Medicaid ID, Address, Date of Birth, Sex (required for Medicaid). If not Medicaid, mark N/A*

Do you have Secondary Insurance?*

What is your availability for sessions?*

Have you have been recently hospitalized for mental health issues or hospitalized in the past?*

Are you currently feeling like you could hurt yourself or someone else?*

Have you had any suicide attempts in the past?*

Attach Files

Attachments (0)

This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.

For fastest response, please email me at

ariella@wildessenceco.com

Phone: (720) 381-0744

4251 Kipling Street, Wheat Ridge, Colorado 80033, United States

Hours

Mon	09:30 am – 03:00 pm
Tue	09:30 am – 03:00 pm
Wed	Closed
Thu	09:30 am – 03:00 pm
Fri	09:30 am – 03:00 pm
Sat	Closed
Sun	Closed

This website uses cookies.

We use cookies to analyze website traffic and optimize your website experience. By accepting our use of cookies, your data will be aggregated with all other user data.