REQUEST AN INITIAL APPOINTMENT ONLINE

We're making it even easier for prospective clients to schedule initial intake sessions through our online intake process. Simply fill out the form below and our office coordinator will contact you within one business day to get you scheduled and to answer any of your questions. Of course, you are always welcome to call us directly to schedule an intake session.

NEW CLIENT INTAKE FORM

Who are you seeking therapy for?
Therapist Preference: (select all that apply)
What type of therapy are you interested in?: (select all that apply)
Select Issues You Would Like to Address in Therapy: (select all that apply)
Mental Health Insurance Provider:

IMPORTANT: 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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