WaitList Submission

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

When there is an opening, you will receive an email with instructions on how to proceed for your initial appointment.

Please add me to the following waitlist:(Required)

Intern Dana Haddan's Payment Options

Complete this section to request Intern Dana Haddan
Self-Pay options for Dana
Clients who currently have Indiana Medicaid or Medicare Insurance will not be billed for services with Dana Haddan.

Select the option that reflects what you can afford. I agree to pay this amount for each session once I start my sessions. No payment required at this time.

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.
Jenelle's Insurance/Payment Options(Required)
I have either Anthem, BCBS, Cigna, UnitedHealthcare, Optum, BeaconHealth, Marketplace, or a form of Medicaid insurance.(Required)

Your Information

This section required for all.
What type of request is this?(Required)
Minor's Legal Name — Complete only if this is a request for a minor Age 11-17

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

Your Name(Required)
Reason for Counseling(Required)
Select all that apply
Availability Notification Preference(Required)