Name *

First Name

Last Name

What type of service are you interested in (please check all that apply)? *

Individual Therapy

Couples or Family Therapy

Psychological Assessment/Testing

Psychiatry/Medication Management

Nutrition Counseling

Functional Medicine

Acupuncture

Physical Therapy

Shamanic Healing

Massage Therapy

Other (Specify Below)

Do you prefer: *

In-person

Telehealth/virtual

Either