Lived Experience Therapy and Consulting

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Reason for care

What brings you here?

Please select the option(s) that best fits your reason for inquiry.

cPTSD Multiplicity/Polyfrag/OSDD/DID LGBTQIA+ ADHD/AuDHD/ASD Lived experience consultation (providers only) Other

Administrative

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Billing & Payment

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Client Preferences

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For example: what you'd like to focus on, what you've worked on in therapy before, insurance or payment questions, etc. Please be as brief or detailed as allotted.

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For medical emergencies, contact your healthcare provider or call 911. For mental health crises, call or text 988.

By submitting this form, you agree to the processing of your sensitive personal information, which may include protected health information (PHI). This information may be viewed by team members in this practice. You also agree not to submit any payment information, including credit or debit card details, through this form.