Contact Us

Name *

Name of person completing form

First Name

Last Name

I am seeking support for: *

Myself, an adult

Myself, a minor

My child, a minor

A referral or client

Other

Name of client seeking support *

First Name

Last Name

Phone *

(###)

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What type of support are you seeking? *

Note: In order to bill insurance, I must diagnose with a mental health disorder with a treatment plan focused on the symptoms of that disorder. (I am unable to diagnose with a mental health disorder just to utilize insurance and then work with you solely on Financial Therapy if it is not applicable to your mental health diagnosis and treatment plan).

Individual Mental Health Therapy

Couple's Therapy

Focused Financial Therapy (private pay)