Email Address

Are you 18 years of age or older

If you are younger than age 18, your parent/legal guardian must consent to services before scheduling can occur.

Parent/Legal Guardian Contact Info

Please provide the name and phone number or email to your parent/legal guardian.

What specifically can I help you with?

In a few words, describe the areas of concern.

Have you used a counselor/therapist before?

How should I contact you?

What is the best or prefered way to contact you?

What are the best times to reach you?

Please indicate a time where you can communicate freely for at least 15 minutes.

Referred by

Please indicate who you were referred by.

LET'S TALK

Ready to take the next step? Please fill out the inquiry form below, click submit, and a clinician will reach out to you.