Appointment Request


To schedule an individual, couples, or family therapy appointment or to obtain additional information about any of these counseling services, please fill out the form below or give me a call.  Please note that your appointment will not be given to you until we receive the registration form back and you are contacted to set up your first appointment.  Usually, we are able to get you an appointment within a week of when we receive your registration paperwork back, so please give us a call at (434) 929-0355 as soon as you know that you want to start therapy.  

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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