WaitList Submission

Treatment Model

Jenelle’s developmental treatment model addresses the root issues by focusing on the underlying causes rather than the symptoms. Addressing our trauma and wounds re-establishes the firm foundation we were meant to live in from the womb. We bring truth into our past, reconnecting with our worth and value. Our present struggles prove that root issues cannot be kept at bay forever.

Please complete the form below to be added to the waiting list.

When an opening becomes available, you will receive an email with instructions on how to proceed with your first appointment.

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
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)
Policy Holder Name(Required)
Legal First and Last Name
Policy Holder Address(Required)
Policy Holder Sex(Required)
MM slash DD slash YYYY
Please upload an image of the FRONT of your insurance card.(Required)
Accepted file types: jpg, jpeg, png, gif.
Please upload an image of the BACK of your insurance card.(Required)
Accepted file types: jpg, jpeg, png, gif.

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