Before we meet, I'd like to take a second and get to know you a little better.
If you don't mind, fill out the form below and once you are through, hit submit, and I'll be in touch within 24 hours or less.
Date of Birth
If you feel comfortable, describe what brings you to therapy at this time:
Feel free to be as brief or detailed as you like. This is a confidential form for your protection.
Have you seen a therapist or counselor before? If so, when and for how long?
What do you hope to gain through personal therapy?
Is there anything else you would like for me to know at this time?
Do Not Fill This Out