This form will gather the necessary information for Kimberly Louvin LCSW to reach out to you regarding getting started in mental health therapy, scheduling an adult autism assessment, or helping you find a referral to a therapist who is able to help you.
Completion of this form does not guarantee services and is not an indication of establishment of a client-provider relationship.
All information collected within this form is stored in a secure manner only accessible by Kimberly Louvin, LCSW.