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Inquiry Form
Full Name
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Email
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Phone
Looking for...
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therapy for myself
therapy for someone else
LPC Associate supervision
Looking for help with...
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Anxiety
Depression
Eating disorder
Body Image
Perfectionism
Suicidal Ideation
Self harm
Other
The best time for a discovery call is:
Morning
Afternoon
Evening
Other
Payment option
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Aetna Insurance
Private pay daytime hour (Individual: $190)
Private pay premium hour (Individual: $225)
LPC Associate supervision ($130)
My Therapy History Includes...
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Anything else you'd like to add to help clarify what you are looking for?
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