GETTING STARTED

Please fill out the form to start therapy. We will set up an initial 20-minute Zoom video call to explore what you would like to work on. You can ask me about the process of starting therapy together, and get a sense of my approach and energy. I get the opportunity to hear from you about your specific concerns and goals. We can decide together if we’re a good fit and schedule a first session.

I will respond within 3-4 “business” days.

Name

First Name

Last Name

Pronouns

Phone

(###)

###

####

How did you hear about me?

Referral source

Availability

Please add days/times that you would be available for a consultation call

Are you interested in providing a solidarity fee ($220-250)?

Brief description of your concerns and goals with therapy

E.g. perfectionism, people-pleasing, peacekeeping, gender identity exploration, anxiety, relationship challenges, family conflict, communication, self-esteem

GETTING STARTED

Every day is another chance to practice living out the values that matter most to us, to be our best selves, to be the legacy we want to leave.

- Mia Mingus