Counseling Inquiry Form
Thank you for contacting Intimate Connections Counseling! We have learned over the years that if we gather a bit of information right away, we are much more equipped to get you set up to meet with Kristin, or provide you with other referrals/resources that may fit your specific needs.

Kristin is in the office on Tuesdays, Wednesdays, and sees clients via teletherapy* on Thursdays. (Kristin's schedule is often full with periodic openings).

Feel free to leave answers blank; however, please know that each answer helps us to be able to respond to your inquiry in the most helpful way we can. You should hear back from us, shortly!

Confidentiality notice: The only two people seeing your responses are Kristin and her office manager, Whitney. Additionally, please note that we do everything we can to keep our data as secure as possible; however, whatever information you enter is subject to risks taken when entering electronic data.

Thank you for contacting us and we look forward to working with you!
*(Not all insurance providers will cover teletherapy; please call your insurance provider to verify if this is a covered benefit for you.)

Email address *
Phone Number *
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