AAMFT Supervision Session C

Book Appointment Below (Eastern Time Zone)*

Name*

First NameLast Name

Email*

example@example.com

Phone Number*

Please enter a valid phone number.Format: (000) 000-0000.

Location Confirmation: Supervision sessions can only be booked with clients in the following states: (PA), (NJ), (DE), (TX), (NV), (AZ), (OR), (GA). I understand that my supervisor can only provide supervision services while I am physically present in the state where they hold a professional license. I agree to ensure my location complies with this requirement for every session.**

Please type your state's initials

I agree

Email Communication Consent : I understand that while FaithWorks Therapy uses HIPPA-Compliant forms, standard email is not encrypted. Appointment reminders will be sent directly to the email address provided above. I authorize FaithWorks Therapy to send non-urgent information by email, including: Appointment reminders and scheduling, billing or insurance information and general administrative updates. I may withdraw this consent at any time by notifying FaithWorks Therapy via email sfarquharson@faithworkstherapy.com*

I consent to receive communication by email

1 hr AAMFT Supervision Virtual Session

You will receive a separate email containing the HIPAA-compliant Google Meet link and receipt for payment

$90.00

Total

$0.00

Need help sooner? To request an earlier available slot or emergency same-day session, use space below to type preferred dates & times. If slots are open, you will be rescheduled to the new preferred slot. A confirmation email will be sent.