NCCC Contact Page

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Name of Form
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Your Name* This field is required.
First Name
Last Name
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Your Email* This field is required.
example@example.com
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Your Phone Number
Please enter a valid phone number.
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Your Age
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Partner's Name
First Name
Last Name
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Partner's Email
example@example.com
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Partner's Phone Number
Please enter a valid phone number.
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Partner's Age
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Autism symptoms are presenting for:
Me
My partner
Both of us
Neither of us
One or more children
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ADHD symptoms are presenting for:
Me
My partner
Both of us
Neither of us
One or more children
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What type of therapy are you interested in?
Couples Counseling
Couples Retreat
Individual Counseling
Assessment
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Check COUPLES topics of interest:
Communication
Parenting
Emotional Intimacy
Sexual Intimacy
Anger Management
Money / Spending
Time Together & Apart
Sharing Chores
Autism & Marriage
ADHD & Marriage
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Check ASSESSMENTS that may be of interest:
Relationship Assessment
Autism Assessment - $1,500
ADHD Assessment - $900
Dual Assessment (ASD and ADHD) - $1, 800
Alexithymia Assessment - $300 (as an add on to the Autism or ADHD assessment)
Sensory Assessment - $300 (as an add on to the Autism or ADHD assessment)
PDA Assessment (Pathological Demand Avoidance) - $300 (as an add on to the Autism or ADHD assessment)
Dyslexia Support
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Check SPECIALTY topics of interest:
Alexithymia
Eating & Autism
Art Therapy & Autism
Cancer & Autism
Seniors & Autism
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Are you interested in a Neurodiverse Couples Retreat?
Yes
No
Maybe
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Where do you live? (This impacts whether you are matched with a neuro-informed therapist or coach)* This field is required.
California
Not in California
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SS - Your therapist or coach preference:Sorry, we don't have any non-binary therapists available at this time.
Female
Male
No gender preference
Incorporates Spirituality/Religion
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My fee is $400 per 50 minute session. If this exceeds your budget, please let me know how much you can afford and I'll connect you with a colleague. My budget per session is:* This field is required.
$300 and up
$250 to $300
$200 to $250
$150 to $200
$100 to $150 - considered "Sliding Scale". Appointments at this price are limited and may not be available.
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I'd love to hear any additional background that you would like to provide:(OPTIONAL)
Huge
Large
Normal
Small
Ok
Ok
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