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Blue Mountains
Blue Mountains

Appointment Request

 


To schedule an individual, couples, or marriage therapy appointment or to obtain additional information about any of these counseling services, please fill out the form below or give me a call.  If I am unavailable please leave a message on my confidential voicemail.  I look forward to getting back with you about any questions you might have and information for your first visit. 

Please note: It is important to understand that email communications are not always encrypted and therefore are not secure communications.  If you elect to communicate from your personal or workplace computer, you should be aware that others may have access to these communications.  Also, email communications may become a part of your client record.

Email communication should never be used in the case of an emergency, for urgent information requests, or to communicate sensitive information.
 

We are committed to your privacy. Do not include confidential or private information regarding your health condition in this form or any other form found on this website. This form is for general questions or messages to the practitioner.

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By clicking send you agree that the phone number you provided may be used to contact you (including autodialed or pre-recorded calls). Consent is not a condition of purchase.

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Helpful Forms

Click here to view and print forms for your appointment.

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