New Client Inquiries

To be added to our pool of potential new clients, please complete the New Client Inquiry Form below.

Please note: this is NOT a waitlist.

We receive more inquiries than we have openings, so we can only contact you if a provider with the right expertise becomes available. For more details, please see our Wait Times & Scheduling page.

If you are experiencing a mental health crisis, please call 988 instead of completing this form.

If you are interested in IQ testing, please see our IQ Testing page, where you can self-schedule directly.

For all other inquiries, including individual therapy, evaluation, medication management, and groups/workshops, please complete the form below.

New Client Inquiry Form

Prospective Client's Name

First Name

Last Name

Prospective Client's Age

What Services Are You Interested In?

Individual Therapy

Evaluation/ Testing/ Diagnosis

Groups (Click to see options)

Medication

Parent Consultation

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 and acknowledge the disclaimers below before submitting

We respect your privacy and take steps to protect it whenever possible, but please understand that electronic communication, including web forms and email, can still be intercepted by a third party.

Submitting this form does NOT create a therapeutic relationship.

You will NOT receive a copy of this form. If you would like to keep a record, please take a screenshot before submitting.

Submitting this form does NOT place you on a traditional waitlist or guarantee you will be offered services.