Book an Appointment

1

Your Name* This field is required.

First Name

Last Name

2

Your Email* This field is required.

example@example.com

3

Your Phone Number* This field is required.Please provide the number in the International Format.: +1 (225) 222-3564

4

What Kind of Appointment Are you Looking for Today?* This field is required.

Telehealth Psychotherapy - 60 Mins

Telehealth Couples Therapy w/ patient present - 60 mins

Free 15-Minute Consultation

5

Who is this appointment for?* This field is required.

Me

My Partner and Me

Someone Else

6

Please select the Options if you fall within these categories.* This field is required.

Veterans & First Responders (high-stress careers support)

Adults (25–50) with trauma, ADHD, anxiety, or life transitions

Couples (trust, communication, attachment issues)

Families (conflict, parenting struggles, adolescent concerns)

BIPOC Clients (culturally affirming therapy)

8

What is your history with mental health?* This field is required.Select all that apply

In therapy now

In therapy in the past

Taking psychiatric medicine now

Hospitalised for mental health reasons now or recently

Hospitalized for mental health reasons in the past

Known neurologic or genetic disorder

Attempted suicide in the past

9

Is there anything else you would like the practitioner to know?* This field is required.For example: what you'd like to focus on, insurance or payment questions, etc.

10

We are a self-pay practice and do not bill insurance directly. However, we can provide you with a superbill that you may submit to your insurance company for possible reimbursement. Do you understand and agree to this policy?* This field is required.

Yes, I understand and agree

No, I prefer to use insurance (please note: we are not an in-network provider)

11

Appointment - 15 Mins

12

Appointment - 60 Mins