Your therapeutic journey starts here - thank you for your interest in our service and responses! Please note that your responses are secure, private, confidential, and HIPAA compliant.  All of this information requested on this form will need to be completed, especially if you are planning to use insurance, in order to request services, as well as prompt the insurance verification, registration, and scheduling process. If you are a parent/guardian completing this form on behalf of your child, please provide their information as the identified client. If you are looking for couples therapy, please designate one member of the relationship as the identified client and fill out the form as such.

We can only provide services to those clients, who are physically located in MN. Please note that due to nature of our outpatient setting, we specifically work those individuals who are experiencing mild to moderate difficulties. If you need immediate mental health assistance and are in the Twin Cities metro area, call **CRISIS (**274747) from a cell phone to talk to a team of professionals who can provide immediate help for you. Please note that we do not begin new therapy cases with clients, who are currently or planning to be engaged in court proceedings. If this is the case, please reach out to us via email and we can provide referrals to other clinics that may be better suited to your needs.