Name * First Name Last Name Email * Phone * (###) ### #### How did you find out about Hungry Heart? * Psychology Today VT Counseling Network Instagram Google Other Are you planning on using your insurance benefits? * Yes, I want to submit out-of-network claims No, I plan to private pay When is a good time for us to meet? * You can expect to receive an email with an invite for a 10-15 minute Zoom meeting within the window of availability you provide Which Hungry Heart Program are you most interested in? Individual Therapy EMDR Extended Session Hungry Heart Experience Self-Sufficiency Program What are 3 of your strengths? Please provide some information about your current experience and goals for treatment * Thank you! You can expect to receive an email response with a link to a video consultation call with Rachel Coster, LICSW, LADC Request a consult today.