Request an Appointment

Filling out this form will let us know who you are and that you would like to schedule an appointment with one of our counselors. When you hit “Send”, our client services team will be notified. After we speak to you, you will receive an email with your official “New Client Intake” forms via the email address you provide. Once the forms are complete, we will be able to confirm an appointment for you.

Name

First Name

Last Name

Telephone Number

This is the number we're going to call to get in touch with you and text you reminders before your appointment.

Message/Reason for Visit

Preferred Payment Method

In-person, tele-health or Spanish?

How did you find our site?