Request An Appointment - Lowey Psychological Services

We’re glad you’re here—please share a bit about what you are looking for, and our team will follow up shortly.

Full Name
Date of Birth
MM slash DD slash YYYY
Gender
Email
Phone
Best way to reach you:
What type of services are you seeking?
Select the option that best fits your needs. If you’re unsure, we’re happy to help guide you.
What type of psychological/forensic evaluation are you seeking?
Please briefly describe what brings you in at this time.
A few sentences is perfect—what’s been going on recently, and what kind of support you’re hoping for.
Do you plan on using insurance?
Insurance Company Name and Member ID Number
Billing Address Associated With Insurance Plan:
Street Address Address Line 2 City State ZIP Code
Insurance Plan Subscriber's Name and Date of Birth:
Please upload pictures of the front and back of your insurance card.
Drop files here or

Accepted file types: jpg, gif, png, pdf, jpeg, Max. file size: 300 MB, Max. files: 5.
Recurring Availability (i.e.: days of week/ times of day available for appointments):
Are you looking for Telehealth or in-person visits?
- Telehealth
- In Person
If no in person appointments are available, would you be open to Telehealth?
- Yes
- No
If you prefer to be seen in-person, do you wish to come to our Center City Philadelphia or Jenkintown location?
Are you open to all of our therapists or do you have a specific preference?
**Please be patient with us while we review the information provided. We will verify your insurance benefits and be in touch about your first appointment within the next three to four business days**