Contact
Schedule an Appointment
To schedule an appointment with one of our providers, please call us at 262-825-5820 or email the following information to appointment@appliedtherapiesandwellness.com:
Personal Information
- Type of service being requested (Therapy, Assessment)
- Name of person being referred
- Date of birth of person being referred
- Purpose of visit (signs, symptoms, behaviors)
- Address and phone number
- Preferred appointment (day/time)
- Referral source (How did you hear about us?)
Insurance Information
- Name of insurance company
- Subscriber’s name
- Subscriber’s date of birth
- Member ID
- Group ID (if applicable)
- Provider telephone number
- Claims address
All information provided will be kept confidential.
