New Client Contact Form

Contact Form

For New Clients
Please fill out the form below today to set up your free 15-20 minute discovery call or to connect with a provider. A member of our team will reach out to schedule your call within 24-48 business hours. We look forward to connecting!

For existing clients, please connect via direct contact with your therapist or by using your client portal. Direct contact information can be found on each therapist's 'about' page.
Confidentiality

Please share what you are comfortable with. We value HIPAA and confidentiality, and it is important to know that this form is encrypted and HIPAA compliant for your privacy.
How did you hear about us?
Referral source
If you were referred by a provider, center or clinic, what is the name of the company or provider?
Name of Referral Source
We'd love to learn...
The person completing this form is...
Name of the client

First NameLast Name
Age of the client.
Preferred pronouns of the client
She/hers, he/his, they/them, she/they, etc.
Name of the person completing this form (parent, loved one, provider, etc.)

First NameLast Name
Who should we ask for when returning your message?
Name
Preferred email
example@example.com
Preferred phone number
Please enter a valid phone number.Format: (000) 000-0000.
Are you okay with us leaving you a text, email, or voicemail?
Please let us know your preferred method of communication.
What therapy location interests you most (in-person or telehealth)?
What type of therapy are you seeking?
Please share a bit about your reasons and desires for seeking therapy.
Please include information relating to OCD/anxiety and information outside of this subject area if relevant. We are here to support you with your OCD and anxiety and other areas of your life.
Please briefly share how much your symptoms, stressors, and/or experiences are impacting you (your child or loved one). We understand how debilitating OCD, anxiety, depression and other concerns can be.
Please share if OCD/anxiety or other stressors are impacting your ability to eat/appetite, sleep, socialize/maintain/develop relationships, mood and energy, regularly attend work or school, suicidal thoughts, fear of leaving house or going certain places, etc. We will discuss this more in detail if you become a client, but this will help us make appropriate recommendations during our free consultation call.
Please share about any preferences in a therapist below.
Please list if you have a preference on the gender of your therapist, preferences relating to religious or spiritual beliefs, in-person or telehealth, certain days you are available (Monday through Thursday only), etc.
Outsmarting Anxiety & OCD (OAO) is a private pay practice, meaning fees for session are due at the time of service. Our standard session rates (45-50 minutes) are $225. All of our clinicians are effectively trained in anxiety and OCD, and we each have our unique niches within our specialization of anxiety and OCD. We collect a credit card to put on file to charge at the start of each session, so we do not have to chat about payment each session for convenience. We accept all major credit cards and HSA/FSA cards.
Outsmarting Anxiety & OCD's providers each have their own unique schedule. OAO therapists provide therapy Monday through Thursday but do not provide therapy Friday, Saturday, or Sunday. The office is closed for the weekend beginning Friday at 12PM; we reopen Monday morning. We will do our absolute best to match you with a therapist who meets your scheduling needs.
Do you have questions for us? Other information you would like us to know? Please share here.
Thank you for reaching out and trusting us to be a part of your OCD and anxiety recovery journey. We look forward to connecting.

- Your Anxiety & OCD Team
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Contact Form

Please fill out the form below today to set up your free 15-20 minute discovery call or to connect with a provider. A member of our team will reach out to schedule your call within 24-48 business hours. We look forward to connecting!

Confidentiality

We'd love to learn...

Thank you for reaching out and trusting us to be a part of your OCD and anxiety recovery journey. We look forward to connecting.