Blue Lotus Psychotherapy Consultation Request
Hi, I’m so glad you’re here 🤍

This short form helps me understand what you're looking for in therapy and whether we may be a good fit to work together.

My work focuses on supporting individuals navigating anxiety, social anxiety, identity, life transitions, and personal growth; especially within the BIPOC and LGBTQ+ communities.

Therapy works best when there’s a strong connection between client and therapist, so this helps make sure you’re getting the support you truly need.

Once submitted, you’ll be invited to book a free 15-minute consultation.

If you are in immediate crisis, please call or text 988 or dial 911.
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Email *
Preferred Name + Pronouns + Age + State *
What is important for you to have in a therapist? If you’ve been in therapy before, what was helpful or unhelpful? *
What problem are you currently struggling with, and how would you like things to feel instead? *
How ready do you feel to begin therapy? *
Not in a rush, just exploring
I’m ready now and want to start soon
My work is short-term (6 months–1 year) and may include reflection, coping tools, and work outside of sessions. Does this feel aligned with what you're looking for? *
Which of the following sound like what you're looking for in therapy? *
Required
How do you plan to pay for therapy? *
Please confirm the following: *
Required

Are you currently experiencing thoughts of harming yourself or needing immediate support?

 *
If no immediate availability, would you like to be added to the waitlist? *
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