Appointment Request

To schedule an individual, children, couples, marriage or family therapy appointment or to obtain additional information about any of these counseling services, please fill out the form below, follow the link to our secure client portal or give us a call. 

If you are a new patient please complete the new patient request or appointment request below. 

If you are requesting an appointment for a minor, family or couples counseling in the notes section please include each person’s first and last name and email address for adult participants. 

If you are a returning patient you are able to request an appointment through the secure client portal. 


We are committed to your privacy. Do not include confidential or private information regarding your health condition in this form or any other form found on this website. This form is for general questions or messages to the practitioner.

Request an Appointment


Please feel free to contact us!