Schedule a Free 15-Minute Consultation

Your Name (adult client or caregiver)(Required)

First Last

Email(Required)

Phone(Required)

Client's Name (if different from above)

First Last

Client's Date of Birth(Required)

I am interested in:

Individual Counseling

Couples Counseling

Family Counseling

Individual Music Therapy

Preferred Method of Payment(Required)

Self-Pay

Insurance

Your Insurance Plan (if preferred method of payment)

Please describe why you are seeking counseling and/or music therapy services.(Required)

Please provide your best availability (days/times) for an initial consultation.(Required)

Preferred Consultation Type(Required)

Zoom (video call)

Phone (audio only)