If you are seeking therapy services, please fill out the form below and a team member will contact you. You may email questions to officemanager@bloomtherapies.com

***Please note, we currently only have openings for new youth and adolescent clients. If you are an adult seeking services, by submitting this form you will be added to our waitlist and a provider will reach out to you directly when they have availability.

Name

First Name

Last Name

Phone

(###)

###

####

Age of Service Recipient

If you are a guardian or caretaker, please provide your name:

What services are you interested in?

Art Therapy

Dance and Movement Therapy

Music Therapy

Other

Do you have insurance?

Who provides your coverage?

Not all providers are in network with all insurance companies, providing this information helps us match you with a therapist.

Why are you seeking services?

It is not necessary to provide this information via the form, but it helps us match you with a therapist. (Only disclose what you are comfortable sharing.)

Contact us

OfficeManager@bloomtherapies.com
Phone: (414) 207-4565
Fax: (414) 348-0206

Main Office

700 W. Virginia St. Suite 204
Milwaukee, WI 53204

Monday - Friday
8am - 3pm

Sessions by appointment only.

Contact us

Main Office

Bloom Art and Integrated Therapies, Inc