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Sign Up for Our Client Wait List!
We would love to help you find freedom from your Eating Disorder and/or OCD! We provide therapy in California, Washington, Utah, Maryland, Tennessee and Florida. We also provide Eating DIsorder Recovery Coaching Worldwide and Clinical Consulting Services. 

You will be contacted to schedule a free 15 min consultation call before booking any services. 

Signing up for my waitlist does not constitute a provider-patient relationship.

 Signing up on this form means that the info you share on here will be available to Allyson Ford, MA, LPCC, her team of clinicians and our client intake coordinator, Georgia Sinclair, ASW. 
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