Request an Appointment
How did you hear about us?
Therapy for Black Girls
Word of Mouth
How would you like to be contacted for appointment scheduling?
What day(s) and time(s) would you like for us to contact you?
I consent to ECC to call/text this number
This is a safe number to be reached at
I agree to check my email if that is the method I chose
What state are you located in? (or country if not US)
What service(s) are you interested in?
Individual Psychotherapy (only accepting adults at this time)
If using insurance, which provider are you covered under?
Out of Network
Any additional information you want to tell us
Should be Empty: