Let’s Connect

Are you ready to start your therapeutic journey? Want to see if we would be a good fit?

Complete the form below and we will reach out to you by phone at the number you provide for a thirty (30) minute consultation call to determine how we can best work together.

Name

First Name

Last Name

Phone

(###)

###

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How did you hear about us?

When it comes to your mental health, what are you currently struggling with most? (feeling misunderstood, anxious, overwhelmed, etc)

What brings you to therapy now?

What have you tried to alleviate these challenges? Have you been to therapy before?

Why is it important to you to resolve these issues?

In terms of therapy is there anything specific you are looking for? (CBT, a therapist that understands my culture, etc)

How committed are you to resolving these struggles and reaching your goals? (1 = not committed, 10 = 110% committed)