Contact Us

Do not use this form to contact us if you feel that you are in crisis or experiencing an emergency. Call 911 or go to the nearest emergency room. This form should only be used to contact us for general questions or scheduling.

Name

First Name

Last Name

Email

Phone

(###)

###

####

Subject

What areas do you believe should be the focus of your therapy or coaching work?

We are primarily providing online services at this time. Are you open to teletherapy or telecoaching?

Yes

No

Are you open to private pay/out-of-network benefits?

Yes

No

If you wish to work with a therapist who is in your insurance network, who is your insurance carrier?

Please list any days/times that do NOT work for you to schedule weekly or bi-weekly appointments.