New Client Form

Hi there,

Thanks for reaching out, our practice is currently at capacity and we are unable to take on new clients at this time. Our colleague and friend Mark Strubler may have openings at his practice if you’d like to also check with him here..

You are welcome to complete the contact form if you would like to be placed on the wait-list and we will reach out as spots open up. We also have two alternative means to get some good work done outside of traditional therapy:

Our next men’s workshop is also live and will center around courageous parenting and will feature a local parenting expert. Check it out here: https://michael-lamerato.mykajabi.com/men's-fall-workshop-courageous-parenting

Our 2nd Annual Winter Nervous System Retreat will be on 1/16-1/18 in Jackson, MI, check it out here.

Take care,

Mike

First name

Last name

Date of birth

Cell phone number

Email address

What brings you to therapy/what are your current biggest concerns?

How would you like to meet? Our in-person office is in Royal Oak, MI, Monday-Saturday

In-person only

Video/Online only

Hybrid/Mix of both

I am also interested in men’s group and/or retreats

When are your preferred times to meet? (Select all that apply)

Mornings

Afternoons

Evenings

Therapy History

Have you been in therapy in the last 12 months?

Yes No

Were you referred by someone? if yes, please share their name/organization below:

May I add you to my quarterly newsletter?

Yes No thanks

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New Client Form

Winter Retreat Registration is live

Winter Retreat Registration is live

Hours of Operation