Institute for Emotional Health
Home
Services
Therapists
Len's In Focus
All Information you provide below is strictly confidential and will be used for the sole purpose of arranging services
between you and IEH.
*
Indicates required field
Name
*
First
Last
Phone
*
Email
*
Your Location
*
Queens
Brooklyn
Nassau
Suffolk
Insurance
*
I have insurance
I do not have insurance - please tell me about my self-pay options
Services Requested
*
Psychotherapy - Adult
Psychotherapy - Child
Family Therapy
Consultation
Assessment
Additional Information
*
You may provide us with additional information about the services you would like or a brief description of your problem.
How did you hear about IEH?
*
Word of mouth
Internet Search Engine
Former Client
Submit