Schedule an Appointment

Schedule an appointment

Once you've filled out the Client Intake Form and we've had our initial consultation, use this form to schedule an appointment for counseling.

For details on fees, payment options, technology requirements, and cancellation policy, see the main Appointments page.

Appointment Request Form

Name *

First

Last

Email *

Type of Session Requested *

Email-Skype Combination Email Only

If email-Skype combination, indicate two or three different times and days you are available. If these times are not available, I'll suggest alternatives.

Available Days & Times *

Annual Income (for determining fee) *

Do you meet the technical requirements for participating in online therapy? *

Yes No

I will respond to your request within two to five days
After confirmation, please set up a payment method with me. Payments through PayPal are preferred.
If we schedule a chat, at the appointed day and time, go online and into our prearranged private chat room. I will be there to greet you!

Request Appointment