Request for Therapy/Counseling
We are honored that you are interested in seeking services with us at Indigenous Circle of Wellness. We invite you to complete this interest and request for therapy/counseling form. It is recommended that you visit our website at to become familiar with our practice, our providers, the services we offer, and our approach to wellness. 

Important note: We only provide therapy services to folks who are in the state of California. It's also important to let you know we currently have a waiting list to begin services. 

If you have any questions, concerns, or would like a list of other trusted providers, please email us at or call us at 626-782-5570 ext. 0.

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