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Getting Started at Inner-Evolution
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Email
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Your email
How did you hear about us?
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Psychology Today
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Name
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Your answer
Age
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Phone
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Services Requested
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Individual Counseling
Relationship Therapy
Anxiety
Depression
DBT (Dialectical Behavioral Therapy)
Ketamine Assisted Psychotherapy (KAP)
Yoga/ Mindfulness Practices
Life transitions- Mid life, Divorce, Chronic Illness, End of Life
Navigating Neurodiversity
Postpartum/Perinatal Mood Disorders
Recovery from childhood sexual abuse
Recovery support from a substance use disorder
Relationship Classes/Webinar
Other:
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Which state do you currently reside in?
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Please describe your current concerns, issues or symptoms.
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What are your desired goals for seeking support?
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Please list all days/times you are available for appointments. We are closed on Sundays.
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Some services may be covered by insurance- depending on your plan and the presence of diagnosable mental health conditions. If you are planning to use your insurance please list who your insurance carrier is.
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Online or In person- check all that apply.
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