Contact Info and Forms

Jasmine St. John MS, LMFT works in Madison, Wisconsin, focusing her counseling practice on couples, relationships, LGBTQA issues, individual concerns, and alternative sexuality.

When you are ready to move forward in reaching your goals…

phone: 608-279-3900

email: jsj@jsjtherapy.com

LOCATION:

55 Oaks Corporate Center

700 Rayovac Dr, Suite 103

Madison, WI 53711

From the East on the Beltline

Take the exit for S Gammon Rd and turn left at the bottom of the exit. Cross under the Beltline and continue to the second set of stoplights. Turn left onto Watts Rd (By Woodman’s Grocery and BP Gas).  Proceed on Watts to a four-way stop.  Continue through the four-way stop on Watts Rd.  As Watts Rd begins to curve to the right it turns into Rayovac Dr.  700 Rayovac is immediately on your right.  There are two entrances into the parking lot.

From the West on the Beltline

Take the exit for S Gammon Rd and turn right at the bottom of the exit. Continue to the second set of stoplights. Turn left onto Watts Rd (By Woodman’s Grocery and BP Gas).  Proceed on Watts to a four-way stop.  Continue through the four-way stop on Watts Rd.  As Watts Rd begins to curve to the right it turns into Rayovac Dr.  700 Rayovac is immediately on your right.  There are two entrances into the parking lot.

From the South on S Gammon Road

Turn right onto Schroeder Rd.  Take the fourth road on the left which is Rayovac Dr.  700 Rayovac is on the left-hand side of the road.  There are two entrances into parking lot.

The building has free parking.  Enter through the main doors.  Turn left by the elevator and follow the hall to Suite 103.  When you arrive, take a seat in the waiting area. All easy! Only the therapy is hard.

APPPOINTMENTS:

Appointments can be made by calling to set up an intake with the therapist. All calls will hopefully be returned within 24 hours.

608-279-3900

FORMS:

Please print and sign these legally protecting forms for before your first session:

Client Bill Of Rights.pdf
Client Information Form.pdf
Biopsychosocial.pdf
Informed Consent Form.pdf
Receipt of Informed Consent.pdf
HIPPA Notice of Privacy Practices.pdf
Receipt of HIPPA Privacy.pdf

OR

Click here to download all of the forms at once

Optional questionnaires:

Do You Suffer From Anxiety.pdf
Are You Depressed.pdf
Are you Experiencing Difficulties in Your Relationship with Others.pdf

EMAIL:

You are welcome to email the therapist directly. All emails will hopefully be returned within 24 hours or less depending on the therapist’s current schedule.

email: jsj@jsjtherapy.com

email – disclaimer

I assume no responsibility for breeches in security or privacy that may result in the exchange of information via email. If you choose to communicate with the therapist via email, be mindful that you do so at your own risk, and that in so doing you agree to assume full responsibility for any awkwardness or consequences that may ensue as a result of breeched privacy issues.

I discourage the use of email for anything more than the dissemination of information and is not a means of therapy which is done face to face. The therapist can provide positive feedback but will likely refrain from clinical input by email. Do not be offended by this as nothing replaces in person therapy as a means to working towards your goals.

Email responses will typically be brief.

Do not assume when you send an email that the therapist has received it. Email is a great tool, but also allows glitches and problems along the way. Sometimes emails simply do not make it to their destination. Always make sure to call the therapist with any time specific or personally sensitive information.

Canceling a scheduled appointment by email is neither reliable nor sufficient. Always call in cancellation notices to the therapist’s office. If you send a cancellation notice by email and your therapist does not receive that email you will be responsible for the cost of that session as an unkept appointment.

©2008 JSJ Therapy. email: jsj@jsjtherapy.com Jasmine St. John, LMFT, WI #788-124

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