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Your name *

Your email *

Your phone number *

Your preferred contact method EmailPhone

Your message Use this space to provide your prospective therapist with brief information about you – why you’re seeking support, your preference for in-person or telehealth services, and how you’d like to be contacted moving forward. Note: Answers to many common questions can be found on the therapist’s profile page. If this is an emergency, please call 911 or go to your nearest hospital.

Disclaimer: uat.therapist.com does not read or retain your email. Please be aware that email is not a secure means of communication and spam filters may prevent your email from reaching the therapist. Please do not include personal identifying information such as your birth date, or personal medical information in any emails you send. The therapist may respond to you by email, although we recommend that you follow up with a phone call. If you prefer corresponding via phone, leave your contact number. Sending an email using this page does not guarantee that the recipient will receive, read or respond to your email.

Your name:

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