Appointment Request/Contact Me


Please answer the following questions in the form below under the "your message" area.  An appointment cannot be scheduled until these questions are completed.  I will get back to you within 24 hours.  Thank you!

* If you are using your health insurance, you may need to contact your insurance company in order to find out how they cover behavioral health same as your medical coverage and is not usually listed on your insurance card.

  1. Are you in the state of Arizona or Florida?
  2. What would you like to accomplish in counseling?
  3. Do you prefer telephone or video conferencing for appointments?
  4. Days and times you are available for appointments?
  5. If using insurance:  What is the name of  your Insurance company?
  6. For Behavioral health......What is your Deductible Information?    How much of your deductible have you met?  Copay/coinsurance?

 This form is for general questions or messages to the practitioner.