Free Consult First Name*: Last Name*: Email*: Phone: Therapy Consult for: Business & Life Alignment ChallengesParenting & Relationship Challenges (individual only)Spirituality Conflicts & ChallengesAnticipatory/Grief & LossPost-Partum DepressionWomen & Life Transition Challenges Preferred Payment Method: PPO/POS Insurance: I want a super bill and sessions applied to my deductible. I understand diagnosis must be given.Credit card/cash only. I don't want a diagnosis and my CPA says can take it off my taxes. Invoice me please.Not yet known, I have more questions! I'm willing to participate in online therapy as necessary: [radio* survey default:1 "Yes" "No"] What time of day and day of the week would work best for you? By submitting this form you understand that you are sending it over a non-HIPAA compliant platform. I understand'