HALO Project OKC

13439 Broadway Ext Suite 200
Oklahoma City, OK 73114

Contact Us

Phone: 405-753-4172
Fax: 405-607-1750

Hours of Operation

Monday 8:30 AM – 5 PM
Tuesday 8:30 AM – 5 PM
Wednesday 8:30 AM – 5 PM
Thursday 8:30 AM – 5 PM
Friday 8:30 AM – 5 PM
Saturday Closed
Sunday Closed

Therapy Services Request Form

Phone

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Name(Required)

First Last

Email(Required)

Phone(Required)

Age of Client

Please enter a number from 1 to 99.

Insurance Provider

In the event that we are unable to accept your insurance, are you willing to explore private pay options?

Yes

Availability(Required)

Mornings (8am-12pm)

Afternoons (1pm-5pm)

Evenings (5pm-8pm)

Virtual

Availability Notes

Therapist Preference

Are you interested in Information about Making Sense of Your Worth Group?

Yes

How did you hear about HALO?(Required)

If other, please explain:

Please give us a brief explanation of your needs and how we can help.

Note: This form is not a confidential or “HIPAA-compliant” way to contact us. General inquiries are welcome, but please do not send personal and confidential information through this form.