Thank you for considering us
for your counseling needs

Please request an appointment by
filling out the form below.

Be sure to include preferred days and times
so we can better meet your needs.

Name
Email Address
Phone
Comment

If you have mental health insurance please let us know.
If you want your therapist to contact your insurance provider to determine your coverage please include the following information:

  Client's name and date of birth
Insurer's name and date of birth (if different)
Company insurer works for and group/policy number
Insurance company and phone number

What to expect on your first visit ...

We request that you arrive at our office 10 minutes prior to your appointment so that you may complete a new client information form. Upon your arrival, please flip the switch next to your therapist's name and make yourself comfortable. Your therapist will greet you and provide you with a questionarire to complete prior to starting counseling. During the beginning of your first session your therapist will briefly review the questionaire to make sure we have all information required for our records. Your therapist will also explain our policies regarding confidentiality and fees associated with your therapy. Ask your therapist any questions you have about therapy; as they are there to serve you and to make you comfortable during this process.

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