Request a Consultation

This is a brief form to help determine whether a therapy intensive is a good fit for what you’re looking for.
Please answer honestly. There are no right answers.

First Name *

Last Name *

Email *

Phone *

What is bringing you to consider a therapy intensive right now? *

Which of the following feels most accurate for you right now? (select all that apply) *

What feels most true about your readiness right now? *

Therapy intensives are a private-pay service. The 3-hour intensive is 777. Does this align with what you are currently able to invest in yourself *

What is your general availability? *

Is there anything else you want me to know before we speak?