Let’s Work Together

Please complete the form below.
I will reach out to you within 2-3 business days to schedule a free 15 minute consultation call (if appropriate) where we will discuss what you are looking for and if it seems like I am a good fit.
If we decide to move forward, we will schedule an intake appointment* and I will verify benefits with your insurance (if appropriate). An account will be created for you in the secure patient portal with intake forms to complete.
*Scheduling an intake does not guarantee follow-up sessions.

Name

First Name

Last Name

Name you go by

Pronouns and Gender Identity

Date of birth

MM

DD

YYYY

Email

Phone Number

(###)

###

####

What services are you interested in? (check all that apply)

In person individual therapy

Virtual individual therapy

In person couples therapy

Virtual couples therapy

What are you hoping to address in therapy?

Insurance Provider

How did you hear about Boyer Psychology?