Appointment Request Form / 15-Minute Consultation Call

Our first available appointments are in January 2026.

Please correct the errors described below.

Please complete the form below.

By law, we are licensed to work with clients in Texas only

Important Notice: This form does not guarantee a consultation. This form is for non-urgent inquiries only and is not monitored for emergencies. We do not provide crisis or same-day services for prospective clients. If you are experiencing a mental health crisis or a medical emergency, please do not use this form. Instead, seek immediate help by:

  • Calling 911 or going to the nearest emergency room
  • Calling or texting 988 to connect with the Suicide & Crisis Lifeline
  • Texting HOME to 741741 to reach the Crisis Text Line and speak with a trained counselor

Your safety is the priority—please reach out to these resources if you need immediate support.

Your information will be encrypted.

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