Take the first step...
Thank you for your interest in getting started in therapy. Provide us with your contact information so we can get started. Your data is safe with us. We will never sell your contact information to any third parties.
Patient Full Name
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First Name
Last Name
Patient (or Parent) Email
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example@example.com
Patient (or Parent) Phone Number
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Please enter a valid phone number.
Do you grant permission for us to text you at this number?
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Yes
No
Is it OK to leave a voicemail at this number?
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Yes
No
Requesting an appointment is a double opt-in process. That means that this short contact form is the first of two forms you will need to complete. Please select the option below that best describes your intent.
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I am only slightly interested in getting started. I invite the Austin Mindfulness Center to try to reach me via email and phone, but I probably won't answer or reply.
I understand that this is a two-step registration process. I am ready to get started in therapy, and I commit to filling out the next form to begin the formal scheduling process.
Next Step
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