BOOKING an INITIAL CONSULT
Please fill this out and I will get back to you to book a free initial call of 20-30 mins to discern with you the best next steps.
Who is seeking to create positive change and grow through therapy?
Clear selection
How MOTIVATED is this person to GROW and EVOLVE?
No desire, actually...
DO WHATEVER IT MAY TAKE!
Clear selection
What is your biggest HOPE and WISH for therapy?
What is your biggest CONCERN (for you or the person you are inquiring for)?
Do you understand the rates (see website) and/or about whether your insurance covers REGISTERED PSYCHOTHERAPISTS (RP) or not?
Clear selection
IF we both decide that it is a good fit and you (or the person you are seeking help for) is ready to change...
Would you prefer to...?
Clear selection
WHEN would you be able to come IN PERSON?
NOT possible
DOABLE
FIRST CHOICE!
TUES - 8am
TUES - 9am
TUES - 10am
TUES - 11am
TUES - noon
TUES - 1pm
TUES - 2pm
TUES - 3pm
TUES - 4pm
Friday daytime (10am - 6pm)
Clear selection
If the options above would not work or are not preferred, please suggest when you would be available...
To be able to REPLY to your request, please type in your FIRST name + best EMAIL ADDRESS please:
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This form was created inside of Powerful And Loving (PAL).