Request An Appointment

We are making it even easier for potential clients to begin the scheduling process.

The following Intake Form is sent to our office admin who will contact you within one business day to get you scheduled or to answer any of your questions. You can also contact us by phone or email to speak directly to our office admin.

Select Issues You Would Like to Address in Therapy: (select all that apply)

NEW CLIENT INTAKE FORM

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Who are you seeking therapy for?
Therapist Preference: (select all that apply)
What type of therapy are you interested in?: (select all that apply)
Mental Health Insurance Provider:

TIP: IF YOUR INSURANCE IS NOT LISTED ON HERE, THAN WE ARE NOT ACCEPTING YOUR INSURANCE AT THIS TIME. CLICK HERE TO FIND OUT ABOUT OUT-OF-NETWORK BENEFITS.

If you would like to use your insurance, please provide the following information: 

How did you hear about us?
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