Let’s get started!

Schedule a free 15-minute consultation with us—we’ll answer your questions and match you to the right therapist for you.

Name

First Name

Last Name

Email

Phone

(###)

###

####

Are you interested in working with a particular therapist?

If so, select their name below.

Please tell us what your preferred days and times are for you to attend counseling sessions.

How do you prefer to be contacted to schedule our consultation?

Is there anything you'd like to share with us prior to our conversation?

Note: Please do not include Personal Health Information in this form.