Therapy Consultation Request

Thank you for your interest in therapy services with Katie Monroe, LCSW. Please complete the brief form below to request a complimentary 15-minute consultation. This consultation provides an opportunity to briefly discuss what you're looking for, ask questions, and determine whether we may be a good fit.

Full Name

Email Address

Phone Number

Preferred Method of Contact

Email Phone Text

Are you currently located in California?

Yes No

What are you hoping to receive support with?

What days/times generally work best for a 15 minute consultation?

I understand that submitting this form does not establish a therapist-client relationship and that this form should not be used for urgent or emergency concerns.

Your information will be encrypted.