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Living Sound Therapeutic Services

If this is an emergency, please call 911. If you have any questions, please call or email our office at Tel: (360) 705-9835, Fax: (360) 956-1170  or Admin@livingsound.net

Request Services

Contact Information

This form is to request mental and/or behavioral health services at Living Sound Therapeutic Services. 

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PLEASE NOTE: Estimated time varies depending on insurance, concerns, provider preferences, and availability. Once the form is submitted, our office will email you within a few business days to confirm receipt.

Legal Sex (for insurance)
Okay to leave voicemails?
Okay to leave voicemails?

Insurance Information

Relation to Subscriber
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Relation to Subscriber
Upload File
Upload supported file (Max 15MB)

Are you covered under Medicare?

Reason for Seeking Services

Mental Health
Specific Services

If you selected "Other," please explain. Any information provided helps therapists determine if their experience and credentials match what you are looking for.

Current Concerns

Are you currently experiencing domestic violence?
Will gender or sexuality be a topic that is discussed?
Will sex, sexual concerns, or sexual kinks/fetishes be frequently discussed?
Are you currently having health concerns that are being treated by a physician?
Are you currently experiencing suicidal thoughts or self-harming behaviors?

Current Concerns

LS is required to abide by legal parenting plans, guardianship documentation, restraining orders, and related legal documents. We are required to receive consent from any adult with decision-making ability for non-emergency medical treatment for children under 13 years old (RCW 71.34.530), and for children under 18 who are not attending counseling voluntarily (RCW 71.34.650).

Are the client's biological parents married?
Is there a parenting plan in place?

If yes, a copy is required to stay on file. Please attach, email to: admin@livingsound.net, or fax to 360-956-1170.

Upload File
Upload supported file (Max 15MB)
If bio parents are not together, who has decision-making ability for non-emergency medical treatment?

Preferences

Therapist Preference

Availability - What days or times generally work best for scheduling appointments?
Our office hours are Monday - Friday, 9 AM - 6 PM.

Time
Day

Please note, afternoon and evening times are the most highly demanded and will likely result in a longer wait time.

Do you prefer Telehealth or in-person appointments?

In order to have a Telehealth appointment, the client must be physically located in the state of Washington due to provider licensure.

In order to receive services sooner, are you willing to schedule outside of your preferred time or method?
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Thanks for registering!

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Address

3627 Ensign RD NE
STE B, Olympia WA 98506

Contact Info

Tel: (360) 705-9835
Fax: (360) 956-1170
Admin@livingsound.net

Schedule

Mon - Fri: 9am - 6pm
Saturday: Closed
Sunday: Closed

Copyright © 2025 Living Sound Therapeutic Services. All Rights Reserved

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