Schedule a Session

Fill out the form below and we will respond within 24 hours! From there we can get your son or daughter booked for an intake assessment. We will send you an email with paperwork to complete online! We look forward to working with you.

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Your Name (required)

Your Email (required)

Phone Number (required)

How did you hear about our services? (required)

Mental Health Insurance Company (required)

Insurance Card

Click or drag files to this area to upload. You can upload up to 2 files.

Upload front and back of insurance card

Name of Person [Receiving Counseling] (required)

Which clinician do you prefer?

What times are you available for counseling appointments?

9am - 12pm
1pm - 4pm
5pm - 8pm

Please know if you are available for a 12pm appointment that would be the start time of the appointment, not the end of the appointment time.

Would you prefer in-person or virtual counseling appointments?

If the person receiving counseling is school-aged, would you be willing to bring your child during school hours in order to be seen sooner? (Skip if not applicable)

If selected, your son or daughter would be given a Letter of Excuse so that they are not marked unexcused during their appointment time.

Brief description of why you are looking for counseling

How would you prefer us to contact you back?

Providing counseling for teens to help them gain a positive self-image while learning how to build healthy relationships and cope with life’s challenges.