WE WOULD LOVE TO HEAR FROM YOU Please fill out the form below to schedule a complimentary phone consultation. Name * First Name Last Name Email * Phone * (###) ### #### Pronouns Why are you reaching out for therapy at this time? * We do not accept insurance, but can accept HSA/FSA accounts. * I understand this is self pay therapy I will use my HSA/FSA account When are you available for phone consultation? * check all that apply Mornings Afternoons Evenings Past mental health diagnoses * check all that apply Depression Anxiety PTSD OCD Substance Abuse Psychosis Eating Disorder Borderline Personality Disorder Postpartum Depression Postpartum Anxiety Birth Trauma Neurodivergence Other Not Applicable Which state do you reside in? * Colorado Massachusetts North Carolina South Carolina Vermont Which therapist would you like to meet with? * Elizabeth Shana I'm open, you can choose How did you hear about us? Google Medical Provider Psychology Today Therapist Referral Friend/Family Member Social Media Other Thank you! We will reach out soon.
