Contact Me Interested in working together? Have a question? Fill out some info below and I’ll be in touch shortly! Name * First Name Last Name Email * Phone (###) ### #### What services are you interested in? * Individual therapy for adult or adolescent Couple, polycule, family or friend therapy Ketamine-Assisted therapy Coaching, classes, or consultation Where do you prefer to meet? in office in nature online How did you hear about me? * Referred by a freind Referred by a therapist AEDPinstitute.org PsychologyToday.com BayAreaOpenMinds.com Google Search Other How do you prefer to be contacted? * e-mail text phone call Anything else you'd like me to know? While I am the only one who will read this, this form is not HIPPA compliant, so please do not share sensitive health information here. Thank you! I will reply within 3 business days. If you are experiencing a mental health emergency, please call or text 988. You can also visit their website to live chat with a crisis counselor.
