Schedule An Appointment

Name *

First Name

Last Name

Phone *

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What are you looking for? *

Individual Counseling

Couples Counseling

EMDR

Preferred Session Format *

Telehealth

In-Person

No Preference

Do you have insurance? *

We accept Blue Cross Blue Shield, BCBS Turquoise Care/Centennial, Cigna, Magellan, NM Medicaid, Presbyterian, TriWest, United, and private pay.

Yes

No

Consent to Contact *

By submitting this form, you agree to be contacted by Sealight Wellness about available services. This form is for general inquiries only; please do not share sensitive health details.

I Consent