Request an Appointment with Melanie

Hello, and thanks for reaching out to inquire about starting therapy with me. Please fill out the form below to get on my waiting list, and I will reach out when I have availability.

Name

First NameLast Name

Age

Phone Number

Format: (000) 000-0000.

Email

example@example.com

Reasons for Seeking Therapy

Do you have a preference for Day of Week and Time of Day, or would you like a first available appointment?

How frequently do you prefer to meet?

I prefer to meet:

Our rates are $150/Assessment and $130/55 minute session. Please select your preferred method of payment.

If you plan to use insurance, what kind of insurance do you have?

If you do not see your insurance listed above, please visit our website here to find a provider that is in network with your insurance.

Do you have any questions before we schedule?

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