Please complete the information below. Once submitted, you will receive a link to schedule your phone consultation meeting.

First Name

Last Name

Phone *

Email *

Is it okay for us to leave a voicemail?

Unfortunately we cannot work with Medicaid. Do you have Medicaid? If so, we are not able to work with you. *

Services You're Interested In:

Child Therapy

Independence Focused Therapy for Child Anxiety

Adult Therapy

30 Day Intensive Therapy (sessions 3x per week + text support for 30 days)

ADHD/Autism/Other Testing

If you are seeking services for a child/teen under 18: Are there other parents or guardians who need to provide consent for your child to obtain therapy services?

If you are seeking services for a child/teen under 18, what is the age of the child?

Name of doctor or therapist if referred by someone:

Please select a therapist preference below. Learn about therapist specialties here.

Therapist Preference

What is your biggest struggle? If requesting for your child, what is their biggest struggle?

What would successful therapy look like? What would be different when therapy is over?

We do not accept insurance. We do accept HSA, FSA, and credit cards. You'll be responsible for the full fee at the time of session. You may be eligible for out of network reimbursement from your insurance company. You can check your out of network benefits by calling the phone number for behavioral health on the back of your insurance card. We're happy to provide a superbill for you to submit to your insurance company for potential reimbursement. What questions do you have about fees or out of network reimbursement?

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Need additional assistance? Text HELP to 314-462-2965