Brauer Health LLC | SimplePractice

Who would be receiving care?

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Billing & Payment

If we decide to work together, how would you like to pay for services?

If you plan to use insurance benefits or seek out-of-network reimbursement, please upload the front and back of your insurance card below.

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Reason for care

What services are you interested in?

Briefly share what brings you here and what you’re hoping to work on. If you’re reaching out about speaking or consultation, please share a little about what you’re looking for.

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For medical emergencies, contact your healthcare provider or call 911. For mental health crises, call or text 988.

By submitting this form, you agree to the processing of your sensitive personal information, which may include protected health information (PHI). This information may be viewed by team members in this practice. You also agree not to submit any payment information, including credit or debit card details, through this form.