Appointment Request

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To schedule an individual or couples therapy appointment or to obtain additional information about any of these counseling services, please fill out the form below or call my mobile office phone.

**NOTE: EMAIL IS NOT A SECURE MEANS OF TRANSMITTING CONFIDENTIAL 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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