Want to learn more about therapy, have questions, or check in before booking? Book a free 20-minute phone consultation. After completing this form, you will receive an email confirmation within 24 hours of your scheduled consultation time. Name * First Name Last Name Email * Phone Number (for consult call) * (###) ### #### What type of therapy are you interested in? Individual Therapy Couples Therapy Preferred Date #1 * MM DD YYYY Preferred Date #2 * MM DD YYYY What time(s) are you available on the selected date(s)? * Thank you!