Create a Confidential Account
Click below to fill out an application.
This application and your answers are stored in my HIPPA complaint electronic medical record. You can answer as much or as little as you like, but please give me your Name, email and cell phone number. The final page is the insurance form, so if you plan on using insurance, please fill that page out completely. Filling out this application does not constitute a therapeutic relationship-that is established at the first in-person meeting.