Open Meadow Therapy

Therapy Services
Inquiry

I’m glad you’re here. This brief form helps me understand if we might be a good fit to work together. As a therapist specializing in Veterans, military spouses, first responders, and adults impacted by trauma, I’m honored you’re considering working alongside me. Please answer transparently. There are no right or wrong answers.

— Beth

Name (First and Last) * Please enter your name.

Are you located in California? *

Yes, I am a California resident I split time between CA and elsewhere No, I live in another state

Please select an option.

How did you find me? *

Psychology Today Friend or client referral Referral from therapist or provider Google search TikTok Other

Please select an option.

Which best describes your connection to military service?

Combat Veteran Veteran Active Duty Service Member Military Spouse / Partner Civilian with trauma history None of the above

What are your main focus areas? (Select all that apply)

Combat PTSD / Trauma / PTSD Military Sexual Trauma Transition to civilian life Relationship issues Anxiety Depression Women’s trauma recovery Men’s trauma recovery Grief / Loss Other

What’s bringing you to consider therapy at this point in your life? * Please share a little about what’s bringing you here.

Fee acknowledgment *

My fee range is $80–$150 per session based on gross annual household income (sliding scale, self-reported). This is a private-pay practice. I do not bill insurance directly.

I understand and accept the fee range and private-pay model

Please confirm you understand the fee structure.

If we seem like a good fit, how would you prefer I reach out? *

Email Google Meet (video call)

Please select a contact preference.

Your email address * Please enter a valid email address.

Before submitting, please confirm *

I am 18 years or older I understand this is a therapy inquiry, not a therapeutic relationship or guarantee of services If I am in crisis, I will call 988 (press 1 for Veterans Crisis Line) or go to my nearest emergency room

Please confirm all items above.

Thank you for your courage.

I’m proud of you for reaching out.

I will personally review your responses and be in touch within 24–48 business hours if we seem like a strong fit. If I’m not the right therapist for your needs, I will do my best to provide trusted referrals or resources tailored to you.

Bethany Elton, LMFT #160671

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