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Inquire About Therapy

To set up a complimentary 15 minute initial phone consultation, please complete the New Client Inquiry form below (preferred method), or you may contact me directly via email. I aim to review all new client inquiries and respond within one business week.

Please note that I reserve after-school hours exclusively for active child and teen individual sessions, while parent coaching and consultation sessions are scheduled during daytime business hours.

* Please note that the absolute confidentiality of information transmitted electronically via forms or standard email cannot be guaranteed. By choosing to submit this form, you acknowledge and consent to the associated secure transmission risks.

New Client Inquiry Form

Fields marked with are required.

Please provide a brief description of your concerns or goals in seeking services with me.
How significantly do these concerns interfere with daily functioning across different environments?
Environment
Not at all
Slightly
Moderately
Severely
School performance/attendance
Peer relationships/social life
Family life/home routines
Sleep patterns
Limits of Confidentiality