CONSULTATION FORM
Hi! I'm grateful you're here! I'm currently taking some time off, but I'll be back in the swing of things on Monday, Sept 14, and will gladly get back to you then. Thanks for your patience, and talk to you soon(ish)!
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Okay!
Name
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First Name
Last Name
Email Address
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Phone Number
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-
Area Code
Phone Number
How would you like to chat?
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I'm good with email!
Phone call, please!
My fee for each session is $225 and I don't take insurance. All sessions are held online.
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I'm good with that!
Because of (outdated!) telehealth laws, Rebecca is only able to work with clients who are physically located in Missouri at the time of each appointment.
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No problem! I live and/or work in Missouri and will be in MO for our sessions.
Ugh, that's a bummer; I wouldn't be in Missouri for our sessions and understand this means we won't be able to work together.
Tell me what's bringing you here:
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How'd you hear about me?
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Please Select
Google
AI chat
Directory (ie Psych Today; Therapy Den)
Friend/family
A therapist
My doctor
Other
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