Inquiry I’m honored that you are considering working with me. It is important to me to serve my clients in the best possible way. This is a time when we decide if we are a good fit for each other. To assist in this process, please fill out the form below. Please enable JavaScript in your browser to complete this form.Your Name *FirstLastClient Name (if different)FirstLastEmail *Phone *How do you prefer to be contacted? *EmailPhoneYour Interest *Individual CounselingCoachingCouple's CounselingFamily TherapyNeurofeedbackWhat do you want to get out of our time together? *What have you tried already? *Why are you seeking help right now? *What meeting times are you looking for? *What would you like me to know about you? *Are you looking for self-pay or insurance billing? *Self-payInsuranceIf insurance, who is your provider?Do you have any questions for me?How did you hear about me? *MessageSubmit