Consultation Form

Consultation Information


If you are interested in treatment for yourself or a loved one, please use the form below.
For general inquiries, please use our Contact Us form.

    I'm Interested in treatment for:

    MyselfA Spouse or Family MemberA Loved One or FriendA Patient of MineA Client of MineOther


    I am Interested in:

    Mental or Behavioral Health TherapyCounselingOnline TherapyAddiction Treatment


    Financial or Insurance Resources:

    No money or insurance availablePrivate insurance and/or substantial financesPrivate insurance and/or moderate financesMedicare or MedicaidOther or Unsure


    Full Name (required)

    Email (required)

    Phone

    Please provide details on what you’re seeking


    Substance Abuse and Addiction Resources

    National Institute of Mental Health (NIMH)

    Substance Abuse and Mental Health Services Administration (SAMHSA)

    National Institute on Drug Abuse (NIDA)

    MedLinePlus

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