Request an Appointment


*Please note! If you are a student looking for an internship or practicum please visit this page. Please do not use this contact form for marketing or job/practicum requests.*

If you fill out an appointment request please list the following information:

  • Age of child/client
  • Issues of concern
  • Best days/times for appointments
  • Type of insurance that you have
A word about custody:

Please note that we are only able to see a minor child if both custodial parents consent to treatment. If both parents have joint legal custody and one parent consents and one parent does not, we will not be able to provide treatment to the child unless this privilege is given to the consenting parent via a court order. It is always best practice to have both parents involved in treatment, even in high conflict divorce situations, although we realize this is not always possible. We are happy to discuss this issue with you over the phone prior to our first appointment.

Also please be aware that we cannot see any children or families who have ongoing custody cases in court. We will only be able to see children and families who have a permanent custody order in place and are not currently court involved.

Our practice does not provide forensic evaluations, court reports, court testimony, custody evaluations or reunification parenting services. Our primary purpose is to provide support and treatment for individuals and families in a therapeutic environment.




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.

Your Name (required)

Your Email (required)

Type of Insurance

Your Message: Age of child, issues of concern, preferred appointment time