Elizabeth Lindgren, LISW

Elizabeth is joining the practice on January 1st. More information about Elizabeth is coming soon.

Name*
Date of Birth*
MM slash DD slash YYYY
Hidden
Age*
Phone*
Email*
Health Insurance*
How did you hear about us?*
What brings you to Prairie Wellness?*
Please choose all that apply.
Therapist*
If the clinician you requested is not available, would you be open to a referral to one of our other therapists?*
- Yes
- No
What days are you available for appointments? Please check all that apply.*
- Select All
- Wednesday
- Monday
- Thursday
- Tuesday
- Friday
What times of day are you available? Please check all that apply.*
- Select All
- 8 AM - 9 AM
- 9 AM - 10 AM
- 10 AM - 11 AM
- 11 AM - 12 PM
- 12 PM - 1 PM
- 1 PM - 2 PM
- 2 PM - 3 PM
- 3 PM - 4 PM
- 4 PM - 5 PM
- 5 PM - 6 PM
If you were referred to Prairie Wellness, please tell us who it was.
Message
Electronic Security*
Email is not a 100% secure medium. Understanding its security limitations, I opt to use email as a means of communication.
- Click here to accept.
Comments
This field is for validation purposes and should be left unchanged.

Δ

3209 Ingersoll Avenue, Suite 100, Des Moines, IA 50312 | phone/fax 515.207.1705