Thank you for your interest in receiving therapeutic services at Sista Afya Community Mental Wellness. You must be a permanent Illinois resident and above the age of 18 to receive therapy at our practice. We recommend using a desktop or laptop to complete this form.
Please take 5 minutes to fill out this form for those paying for therapy with an EAP company.
ATTN: We do not provide individual therapy for couples and families. If you are looking for a couple's or family therapist, please review our Preferred Providers List at: http://bit.ly/afyaresources
If you have any questions, feel free to reach out to us at: firstname.lastname@example.org . NO PHONE CALLS PLEASE!