Appointment Request

To schedule an individual, couples, or family therapy appointment or to obtain additional information about any of these counseling services, please fill out the form below. Please include the name of a preferred therapist (if you have one) and any applicable insurance information. Be aware that some therapists do not accept insurance or only accept certain carriers. This form will be forwarded to your requested therapist and they will get back to you. 

We are committed to your privacy. Do not include confidential or private information regarding your health condition in this form or any other form found on this website. This form is for general questions or messages to the practitioner.

By clicking send you agree that the phone number you provided may be used to contact you (including autodialed or pre-recorded calls). Consent is not a condition of purchase.

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