Contact Us
Feel free to contact directly the therapist you think would be the best fit for you. Their contact information can be found on the Providers' page. Or simply fill out the form below and we will add your information to our waitlist. 
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Email *
First Name *
Last Name *
Phone Number *
Email Address *
Health Insurance Company *
When are you available to meet? *
Please selection all that applies.
Required
What is the best way to contact you? *
Required
Please select which service(s) you are interested in *
Required
What is the age that best fits the person seeking help? *
Are you comfortable having your therapist be a graduate student intern or a therapist in training? *
Would you prefer your appointments to be held virtually or in-person? *
Do you have any therapist preferences? *
Gender, race, education, background, etc. (If you have no preferences, type N/A.)
Are you requesting a specific therapist? *
Please provide any information below you feel comfortable sharing so that we can best serve you. Thanks!
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