New Client Appointment Request

Existing clients, please use the portal to schedule appointments.

To schedule a therapy appointment or to obtain additional information about any of these counseling services, please fill out the form below. You can try calling the number listed, however, because most clinicians are in sessions often, filling this form out is the most prompt way to get a response.

Please indicate below, which insurance plan you carry. If you don’t have a plan we accept, then please note that you plan to do self-pay. 

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.

Date of birth is needed in order to start a portal.
* Fill out an appointment request if you are READY and SERIOUS about starting your therapy journey. Our clinicians are highly experienced and their time is valuable. We do not accept Medicare or bill secondary insurance. Medicare only contracts with LP's and LICSW's even if you have a secondary plan that is in-network. If you choose self-pay, you can request flex spending statements to submit to your insurance if you don't see your insurance above. ***BY FILLING OUT THIS FORM YOU ARE AWARE YOU ARE SHARING PERSONAL INFO THROUGH A SECURE FORM THAT DOES NOT QUALIFY AS HIPAA COMPLIANT

By clicking ‘Submit’ you agree that the phone number you provided may be used to contact you.