Request Appointment | WaitList

Thank you for requesting an appointment. Complete the form below to provide information needed to confirm we are in-network with your insurance.

  1. You will initially be added to our waitlist.
  2. Our admin, will confirm that we are in-network and that no prior authorizations are required.
  3. When all insurance information is confirmed, you will receive a link via email from the SimplePractice portal to complete all intake forms.
  4. Once you have completed the forms, you will be able to select an appointment available on Jenelle’s calendar.
  5. You will receive a confirmation once your appointment request has been approved.

Looking forward to meeting you!
Jenelle Linden — Owner/Provider

Jenelle Linden

Complete this section to request Jenelle Linden, LMHC, LPC, LCPC.

Jenelle is licensed in IN, MI, and IL and is an EMDR Verified Psychotherapist.
Therapy Options(Required)
Jenelle is not licensed in any other state and can only provide therapy for clients who live in IN, MI, or IL.
What type of request is this?(Required)

Your Information

Your Name(Required)
Sex(Required)
MM slash DD slash YYYY
Legal Address of Client(Required)
Availability Notification Preference(Required)
To help maintain your privacy and confidentiality, please use a personal email address.
Consent(Required)

Reason for Counseling(Required)
Select all that apply

Due to a capacity waitlist, Jenelle Linden is only taking teens who have experienced trauma and/or a chaotic home life.

See link at top of the page to determine ACEs score.

Minor's Legal Name — Complete only if this is a request for a minor grades 7-12.
Grades 7-12 includes current or next school year (if name is added to the waitlist during the summer months).

The email identifies the client in SimplePractice and must be different than the parent/guardian email.

Please complete the insurance information below. We will use this information to confirm that we are in network with your Insurance Payer.

I have either Anthem, BCBS, Cigna, UnitedHealthcare, Optum, BeaconHealth, Marketplace, Medicare, or a form of Indiana Medicaid insurance.(Required)
Medicaid only available to Indiana residents.
Policy Holder - Primary Insurance(Required)
Accepted file types: jpg, jpeg, png, gif.
Accepted file types: jpg, jpeg, png, gif.
Policy Holder Name (If different from Client)
Legal First and Last Name
Policy Holder Address (If different from Client)
Policy Holder Sex (If different from Client)
MM slash DD slash YYYY

Consent to Pay for Services(Required)
Attestation | Legal Authority(Required)