Waitlist

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Waitlist

Waitlist for Telehealth Appointments

This form adds your name to the waitlist for virtual telehealth appointments with Hanna Del Toro, LCSW.

Please note:

Office hours are Tuesday–Friday, approximately 9:00 AM to 5:00 PM.

If you are in crisis, please call or text 988, contact your local crisis center, or go to the nearest emergency room for immediate support.

This form is transmitted via a HIPAA-secure Google Business account. However, as with any online form, submitting personal information carries some inherent risks. If you prefer not to use the form, you may join the waitlist by calling 512-797-5871 and/or emailing info@hannadeltoro.com or admin@hannadeltoro.com.

You will be contacted when a spot becomes available. Thank you for your patience and interest in working together.

Email *

First Name (or first the letters of first name) *

Last Name (Initial Only) *

Email *

I give permission to email me at the above email address (please check the box) *

Yes

No (I prefer text)

Required

Phone number *

I give permission to text to the phone number I provided *

Yes

No (I prefer a phone call when my turn comes up on the list)

No (I prefer an email when my turn comes up on the waitlist)

Required

Brief Reason for Counseling (please select the closest option or other)

Insurance *

Service Requested

Send me a copy of my responses.

Submit

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