New Client Inquiries

If you are wanting to schedule IQ testing for your child, please see our IQ testing page and you can schedule directly.

For all other inquiries, including individual therapy, evaluation, medication management, and groups/workshops, please complete our New Client Inquiry Form below.

If this is a mental health crisis, please do not complete this form, and contact 988.

When you complete the form, you will be added to our pool of potential new clients. Please note that due to the high volume of inquiries, you will be contacted only if an opening becomes available. We do try our best to get back to as many clients as possible!

Read here for additional information for new/ prospective clients regarding insurance & fees, and wait times & scheduling.

New Client Inquiry Form

Prospective Client Name

First Name

Last Name

Prospective Client Age

Prospective Client's School (If Applicable)

Parent/ Caregiver Name (if applicable)

First Name

Last Name

Email

Phone

(###)

###

####

What Services Are You Interested In?

Therapy

Evaluation

IQ Testing ONLY (for school admissions)

Parenting Anxious Kids Group (ages 5-11)

Medication Management

Unsure/ Other

Reason for seeking services

Please provide a brief description of your concerns and goals for treatment/ evaluation.

How did you find out about us?

Are you interested in working with a specific provider?

Please review the disclaimer below and press SUBMIT:

I acknowledge that electronic communication, including web forms and email, is limited in terms of privacy and may be intercepted by a third party. I also acknowledge that this electronic communication does not constitute a therapeutic relationship.

Please note that you will NOT receive an email copy of the form. This is because there is not currently a way to send a copy of the form to you in a HIPAA-compliant way. If you would like to keep a copy for your own records, please screen-shot the form before you hit “submit”.