The Gender & Sexuality Therapy Center
Secure Scheduling Form
To schedule your first session, please complete this multi-page form. For general inquiries, complete our general contact form. To request a benefits estimate, complete our insurance card form. You may call us at (646) 797-4340 with any questions.
 
If you plan to pay at least partially with out-of-network insurance, you may find it easiest to complete this form on your smartphone as photos of your insurance card will be required on a subsequent page.
How would you like us to communicate with you? *
Email Risk Acknowledgement & Use Consent *
Are you over 18 years of age? *
Do you plan to pay for your sessions at least partially with out-of-network insurance? *
Did you already provide your insurance information using our insurance card form*
Secured by Formsite
The Gender & Sexuality Therapy Center
850 7th Avenue, Suite 1106
New York, NY 10019-0029

gstherapycenter.com
(646) 797-4340