Free 15 Min Consultation Request
Thank you for your interest in our services!  

After completing this form, our intake coordinator will contact you via email to answer any questions and will match you with a therapist. In order for us to find the best match, please take the next 5-10 minutes to fill out this form and and share with us who you are and what you are looking for. 
Welcome! Please share your name & pronouns with us: *
What email should we use to contact you? *
By checking the box below, I am confirming that I am at least 18 years old and currently live in California. *
Required
By checking this box below, you confirm that you am aware all services will be via telehealth (video). *
Things to Note About Our Services: 

We are a self-pay practice and only accept PPO Insurance. 

All new clients must be able to commit to weekly sessions for the first six months.

Our fees are the following: 
  • Individual Therapy: $150/session
  • Couples Therapy: $225/session
We offer sliding-scale. Please let us know your budget down below. 
We try our best to make therapy affordable. What is your weekly budget for therapy? *
Please share your 3 ideal day/times for weekly sessions. *
Is there a particular therapist you are interested in working with?  *
What type of therapy are you looking for? *
We're Glad You're Here. Tell us about about yourself. 
What prompted you to seek out therapy? *
What do you see your role being in therapy?  *
Is there something you are looking for in a therapist?  *
Any questions we can answer before your free consultation?
How did you find us? *
Thank you!
Our intake coordinator will contact you to schedule a free consultation with one of our clinicians.

The free 15 minute video consultation is intended to provide you with the space to ask questions about our therapist's style, and experience, and see if it feels like a good match. 

This is not a therapy session and no treatment or interventions will be provided. If you decide to move forward with treatment, you will be emailed intake paperwork and consent forms and a separate intake appointment will be scheduled. 
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