Let’s Work Together

Interested in working together? Fill out some info and I will be in touch shortly to set up an initial consultation.

Name

First Name

Last Name

Pronouns

she/her, he/him, they/them

Birthdate

Email

Phone

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Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Tell me about what you are looking for in therapy:

This can be brief, we will go more in depth in our initial consult