Appointment Request Form

Complimentary 15-Minute Consultation Call

Please correct the errors described below.

Please complete the form below and we will reach out to you within 24-48 hours to answer your questions or to help you schedule your first appointment.

Counseling for Adults 18+ only.
I offer counseling in TX & WA
If you are seeking couples, please provide your partners full name, DOB, email & phone here.

If you are having a mental health crisis please call 911 or go to the emergency room. This form is not to be used for a crisis.

Save our phone number in your cell phone so that you will know when I will call. 325-261-8360 - Elizabeth

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