Intake

You can complete intake for the Wendt Center’s therapy services by phone or by webform.

Call our Team

You’ll leave a message stating:

• Your name
• What service you’re hoping to participate in (or if you’re not sure, that’s okay too!)
• What number we should call you back at
• Some times that are generally best for us to call back

Our staff aren’t able to answer the phone if we’re on the line with someone else completing Intake, but we’ll call you back as soon as we can.

It really helps us get your intake completed sooner if you confirm that your voicemail box is not full and that you return all of our calls.

Fill out this form

Once you complete the form, our team will receive a notification and we’ll try to call you back at one of the times you’ve listed. Please be aware we only make calls on business days, Monday-Friday, and your initial intake will likely be during the day.

Legal Name(Required)

First Last

Preferred name/Nickname

Are you calling to seek services for a minor?

If you are, they must be a minor over whom you have legal medical/legal decision making authority.

Yes

No

Child's Legal Name(Required)

First Last

Preferred name/Nickname

If there are multiple children, add their names below:

Email(Required)

Enter Email Confirm Email

Phone(Required)

What are you seeking services for?(Required)

A loved one has died

I or someone I’m close to was a victim or witness to a crime (whether or not it was reported)

A loved one was diagnosed with a terminal illness

The Wendt Center focuses on therapy for death related grief or trauma. If you believe your reason for seeking services falls within our scope but don’t see it above, you can call (202) 204-5021 to speak with someone.

I'm interested in:(Required)

Individual Therapy

Group Therapy

I’m not sure

If you’re only looking for group therapy, please see www.wendtcenter.org/grouptherapy to bypass this process.

Insurance/Payment Method(Required)

Amerihealth Caritas (DC Medicaid Plan)Carefirst/Blue Cross/Anthem (through employer)Cigna (through employer)HSCSN (DC Medicaid Plan)Medicare Part A&B (no Advantage plans)Medstar Family Choice (DC Medicaid Plan)Wellpoint – formerly Amerigroup (DC Medicaid Plan)Self-Pay/Out of PocketI'm not sure

Best Times to Receive a Call(Required)

Morning 9-11:30

Lunch time 11:30-1:30

Afternoon 1:30-5

If there's anything we need to know about your schedule, please describe:

Information for the Team

If you have any questions for our team, or anything you want to make sure we know, please share it below:

After you complete this form, our Intake team will receive a notification, and we will reach back out to you in the order in which we receive these forms. We hope to respond to all inquiries within 5 business days. This is not a crisis service, and if you need to speak to someone urgently please call 988.

By signing below you affirm that you are seeking services on your own behalf or on behalf of a minor in your care, and that you agree to receive a return phone call from us. If we leave you a message, you must call back in order for us to continue contacting you, or we will assume you are no longer interested in services.

Signature(Required)