Consultation Request: Midwest Center for Transformational Change PLC

Welcome. This form is the first step to scheduling a consultation with Anne Lindyberg, LMHC (Iowa), LCPC (Illinois).

  • Services are available to individuals located in Iowa (in-person or telehealth) and Illinois (telehealth only)
  • This form is not for emergencies → please use appropriate crisis resources if needed
  • Completing this form does not establish you as a client
After submitting, you’ll be directed to schedule a consultation.
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Email *
If you are a colleague who would like to consult, or you are a professional making a referral:
Please request an appointment through this link: https://bit.ly/BookColleagueConsult It is not necessary to complete this form, although for a potential referral, it is recommended, and can be done after booking (the colleague consultation link won't be shared after submitting the form, so it's recommended to schedule first).

If no time is available through the link, please reach out through email at anne@mwcftc.com and share some choices for your availability.

Potential client consultation requests through the colleague scheduler will be declined and redirected to completing this form and making an appointment through that process, using the link that appears after submitting the form.

Requests for supervision should continue with the form and book in the link for client consultation scheduling that appears at the end.
What name would you like me to use? You may also include pronouns if you like. *
Are you filling this form out in order to receive counseling for yourself, or some other person?  *
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