Therapy & coaching inquiry

Tell me a little about yourself and what you're looking for, and I'll reply within two business days to set up a free consult.

This form isn't a secure or confidential channel and isn't monitored around the clock. Please don't include diagnoses, medications or other health details. If you're in crisis, call or text 988, or call 911 if someone is in immediate danger.

First name

Last name

Pronouns(optional)

Age

Phone

Where are you located?

Therapy is available to California residents only. Wellness coaching is available anywhere.

What are you interested in?

Are you interested in telehealth, in-person, or hybrid sessions?

Telehealth / virtualIn-personHybridNo preference

What are you hoping to explore or work on?

Share whatever feels important — goals, what's going on, what you'd like to be different. A few sentences is plenty.

Have you worked with a therapist or coach before?

If so, what did you appreciate, and what didn't work for you?

When are you generally available for sessions?

How did you hear about me?

If you're under 18, please share a parent or guardian's name and contact information.

Anything else you'd like me to know, or questions for our consult?(optional)

I understand this form is not confidential, is not for emergencies, and that sending it does not create a therapist–client relationship.

Therapy & coaching inquiry

In a crisis?