FREE CONSULTATION

Free Consultation Form

We'll review your goals and how to best match the therapist who meets your needs.
Full Name*

First NameLast Name
Phone Number*
Please enter a valid phone number.
E-mail*
example@example.com
How did you hear about us?*
What service are you looking for?*

EMDR TherapyIndividual CounselingCBT for Insomnia (CBTi)BiofeedbackBiosound® TherapyCouples CounselingThe Gottman 7 Principles Program SeminarPlay TherapyChild-Parent Relationship TherapyGroup TherapyOther
Note: Biosound therapy and couples therapy are not services covered by insurance.
Who are the services for?*

MyselfMy childMy partner and IOther
How old is you child?*
According to Texas Administrative Rule §681.35, therapists must have a copy of the custody agreement when parents are divorced, prior to the start of treatment. More information here.
Please select the option that applies to your situation*

Not applicable, parents are marriedYes, I understand. We are divorced and both parents agreeYes, I understand, I am the sole consenting caregiverNo. I will reach back once I have the final decree. (We can still do Free Consultation for information).
Please provide the name, phone number, and email address of the other consenting caregiver:
Name*

First NameLast Name
Email*
example@example.com
Phone Number*
Please enter a valid phone number.
I'm looking for * therapy
For in-person therapy, are you closer to the*

Plano LocationFort-Worth Location
Are you using insurance? Note: Biosound therapy and couples therapy are not services covered by insurance.*

YesNo
Which insurance do you have? (We are not EAP providers, and we are not in network with Medicare or Medicaid)*
Other insurance:*
Select a Date & Time for your free 15 minute consultation*
If you know who the therapist(s) you would like to work with are, please let us know.

Whoever is the best matchAbby ZandevakiliAshley HembrockBradley HutchinsonCarla PintoFlora Lai /賴沅萱Griselda RuvalcabaKeegan FriedrichsLupita LopezMaribel FaucettSara AguilarShlomit OlielVeronica Petty
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Free Consultation Form

Please provide the name, phone number, and email address of the other consenting caregiver: