Inquire about Therapy

Please complete the form below if you’d like me to contact you. Please know that email is not a secure nor confidential form of communication. I respond within a day.

Name

First Name

Last Name

What are the best days and times for you to meet for therapy? Please include time zone, or say Pacific, Eastern or Hawaii time.

Where do you feel stressed, out of balanced, or stuck in your life or work? Please be as detailed as possible, and include any specific areas you would like to work on together.

Have you been in therapy before? How would you like this experience to be similar or different from your previous therapy experience?

Do you understand I do not take insurance and that I am private pay only?

I can provide a superbill which you can submit to your health insurance for possible reimbursement. I do have limited sliding scale spaces, ask if any are available.

Yes

Phone

(###)

###

####

Can I leave a confidential voicemail at this number?

“Healing takes courage, and we all have courage, even if we have to dig a little to find it.”

— Tori Amos