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Get More Information; Apply for a Phone Consultation

Thank you for your interest in our work. To determine if therapy is appropriate for you and set up a consultation (no charge) to discuss your case with a Therapist Director, please complete and return the following questionnaire. You may use any of the methods provided below.

  1. Download and print a copy to complete at your leisure: Print your answers and fax the completed questionnaire to us at 352-336-9980, or mail to us at Clear Passage, 4421 NW 39th Ave, Ste 2-2, Gainesville, FL 32606.
  2. Ask us to send you a copy by mail. Call 352-336-1433 or email info@clearpassage.com.
  3. Complete your questionnaire online . Type your answers directly into the online form and submit via the button on the last page. You will need 20 – 30 minutes to complete the questionnaire. You will be able to print a copy for your own file before you submit via email. If you do not want to send via email you can print a copy, then fax or mail it to us.
    • Note: If you choose this option, you will need to leave the document open on your computer until you have completed all questions, and print or email it. Closing it sooner will delete your information and you will have to start over.
    • Adobe Reader 7 or higher is needed to submit this form online.
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We will mail you a letter advising whether therapy appears appropriate for you. At that time, if you have not yet received it, you will also receive our full introductory package including our Guide to Services, a list of published medical citations about our work, as well as, a comprehensive DVD showing therapy, background and theory, along with patient, physician, and therapist interviews.

Once therapy is determined appropriate for you, you may schedule therapy services. Or if you prefer, you may first schedule a 30 minute telephone consultation with our Therapist Director (free of charge) to further discuss your case. You may wish to review the introduction materials and note any questions you may have for the Therapist Director in preparation for your consultation.

Thank you for your interest. We look forward to helping you reach your goals!

Sincerely,
The Clear Passage staff