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Get More Information; Apply for a Phone Consultation

Thank you for your interest in our work. To set up a consultation (no charge) about your case and determine if you are appropriate for this therapy, 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, 3600 NW 43rd Street, Suite A-1, 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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To get the most out of your consultation, we will send you an introductory package of information to review. This includes a Guide to Services book and a DVD with an explanation of our work, views of therapy sessions, and interviews with patients, physicians, and therapists.

While viewing these materials, note any questions you may have for the Director who will consult with you. We will contact you once we have thoroughly reviewed your questionnaire, and you have had a chance to review the material we send you.

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

Sincerely,
The Clear Passage staff