Client Waitlist
This form is used to help us keep track of who is interested in future services when we are full. We find that the average wait is 2 weeks to 2 months. We try to help place you in therapy as fast as possible.
What is your first and last name, that you go by? *
What is your phone number? *
What is your email? *
What is the age of the person seeking services? *
What do you hope to accomplish in therapy? *
What insurance do you have? *
Do you understand we do not do therapy for couples, family, group therapy, or DUI classes? *
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