Coaching or Therapy: Start Here

If you are in immediate danger, thinking about harming yourself or someone else, or unable to keep yourself safe, call 911 or 988 (Suicide & Crisis Lifeline) now. Outside the U.S., call your local emergency number. Please do not use this form for urgent support.

Full Name

First NameLast Name

Email Address

example@example.com

Phone Number

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

Where You Will Be During Sessions

Are you seeking support for yourself or as a couple?

Partner's name (if seeking support as a couple)

Are you functioning well at work, at home, and socially?

Are any symptoms or patterns you're experiencing manageable enough that they aren't interfering with your daily life?

Can you make progress toward goals you choose?

I'd like faith to be part of my work (optional).

I understand this form does not establish a therapy or coaching relationship, does not provide crisis support, and that Dr. Thompson will review my responses before recommending a next step.

Responses are reviewed Monday through Friday. Dr. Thompson will personally review your responses and reach out to you. How would you prefer she contact you?

I most prefer Dr. Thompson reach me by

Coaching or Therapy: Start Here

Three questions about your current readiness