Client Inquiry Form

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Client Inquiry Form

Taking the first step toward support can feel overwhelming, so we’ve made it simple. This form helps us understand your needs and connect you with the right therapist. We have virtual openings available and can let you know about in-person sessions too. Once submitted, a member of our team will reach out promptly to discuss next steps.

Full Name *

Email *

Phone Number

Birthdate *

YYYY

Would you prefer In-Person or Virtual Sessions?(check any that apply)

In person-Kingsley

In person- TC

Virtual

We have Immediate Openings for Virtual sessions. Are you open to HIPAA Compliant Virtual Sessions from the comfort of your own home if in-person preference is unavailable?

Yes

Clear selection

If you are comfortable, please share in 1-2 sentences why you are seeking therapy today.

Insurance Type *

Anything additional you would like us to know about you or your situation including preferred clinician?

Submit

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