Submit a Therapy Inquiry

Please read below before submitting the form:

Please be aware that

  • Dr. Bastien’s services are only offered through her Virtual Office via VideoConferencing

  • Dr. Bastien’s services are private pay only and she does not work with any insurance companies. Payment is due at the time of service and you will be provided with a "superbill invoice" to submit for potential reimbursement from your insurance company

  • When completing the contact form, please provide the information of the person who needs services.

    • For example, if you are a parent or guardian requesting services on your child's behalf:

      • Please provide your child’s name, date of birth, gender, and email address (if over age 13 years)

      • Please provide your name and email address in the section marked “Is there anything else you want to share?”

Contact Form