Prepare-Enrich Assessments

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Name

Phone

Comment or Message

Select which office/therapy method you would like assistance from:

In-person in Birmingham, AL Online Therapy

Online

In Alabama In another U.S. state

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Yes, I want to submit this form & agree to the terms of use.

Name

Phone

Comment or Message

Select the location where you plan to receive counseling

Do you plan on using insurance to cover your session fees?

If you have Blue Cross Blue Shield insurance, we can file for reimbursement for you. Do you plan to use a BCBS policy?

If you want us to check your policy benefits, please upload a picture of your insurance card and driver's license below. You may provide it later if you are unable to do so now.

Insurance Card Front

Insurance Card Back

Driver's License Front

Prepare-Enrich Assessments

Offering in-person therapy options in Birmingham and online therapy options across Alabama

Office Hours

Office

Contact Information