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Have questions or ready to start your journey toward healing? Reach out to us today. Whether you need more information or want to schedule a consultation, we’re here to help. Your path to clarity, balance, and well-being starts with a simple conversation.

Counseling Interest Form

Client Information

Preferred Counseling Format

Emergency Contact

Medical & Mental Health History

Have you previously received counseling?
Are you currently taking any medications?
Do you have any medical conditions?
Please check any symptoms you are currently experiencing:

Presenting Concerns

Consent and Confidentiality