Cognitive Behavior Therapy (CBT) Center

  • Flexible hours to meet your needs
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Current Patients

Cognitive Behavior Therapy (CBT) Center New Patient Interest Form

Thank you for your interest in the CBT Center!

Please take a few minutes to fill out this quick form. It is important for us to make sure we understand what you need so that we can assess whether us and our services are a good fit for what you need right now. We practice only the most evidence-based treatments and want to make sure we have the expertise to help you.

We reach out to potential patients as soon as possible when we have an opening. Please keep in mind that there is a high demand for our services and our therapists often have waiting lists.

This form should only be completed by people 18 years and older. If you are younger than 18, please have a parent or legal guardian complete it for you.

*Indicates required question

Please note: We generally treat middle school-aged through older adult - ages ~12+ (we have some availability for grade school-aged kids)
*If you currently are having suicidal thoughts in addition to having plans or the means to do so, please go to the nearest emergency room, call 988, or text “START” to the Crisis Text Line (741741). If you are outside of the country, please call the local emergency line immediately.*
You will be required to pay for your session in full at the time of service. We will provide you with a superbill (statement for insurance reimbursement) at the end of each month that you can submit to your insurance company for reimbursement. We accept cash, check, or credit card; however, we require a credit card on file.

*To learn more about our current fees and insurance, visit the FAQs (https://cbtcenter.org/faq/) page on our website.*

Please confirm that you are willing to pay out of pocket for our services by initialing below indicating that you understand that the CBT Center is an out-of-network provider and you are willing to pay out of pocket for their services.
Note: We meet patients in-person in Central NJ and in Riverhead, NY. We treat virtually from 40+ states!
Spoiler alert: scheduling is one of the bigger barriers to getting an appointment. The more flexible you can be, the sooner we can get you in to see one of our CBT clinicians.
You can read more about us at our website -
 https://cbtcenter.org/about-us/