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Verge Therapy
Florida Telehealth Referral Form 

Thank you for your interest in Verge Therapy! If you are interested in becoming a client at our practice, please respond to the questions below. As an opening becomes available our Referral Coordinator will call or email you. Please feel free to reach out with any questions. 




We do not currently accept insurance in our Florida location. All services rendered are through private pay.

Method of Service Payment
Type of Services Requested

Please understand that we do our best to assign you to your preferred clinician. There are times when clinicians are no longer accepting new clients, or do not match your availability. We will actively review your information to find the next best-fit clinician

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