All of us need help sometimes. Get your individualized support starting today!
Meet your therapist…
This is a confidential form. All services will comply with HIPAA confidentiality standards.
Your Name (required)
Your Email (required)
Please confirm your email (required)
Are you suicidal?
Which paid service are you requesting?
CounselingPsychotherapyDream TherapyDreamWorkLife CoachHuman Design
Would you prefer online counseling, face-to-face counseling (in person), or both?
OnlineIn-PersonBothI don't know
State of Residency (required)
Your Brief Comments
Or contact Chris directly at (479) 308-1901