Thank you for your patience.

I know it’s been a pretty difficult year (and then some), and it’s very frustrating to want help and not be able to access it. I’m doing my best to juggle things to accommodate as many people as I can, while maintaining boundaries to ensure I can still provide a high quality of care. When you are scheduled, I want to show up as my best self for you just as I do for others.

Please complete the form below to update me on your preferences while waiting for an appointment.

Name

First Name

Last Name

Email Address

Waiting List status

I'd like to remain on the waiting list

Yes

Maybe, depends if I schedule elsewhere

Sessions

If vaccinated:

I will want to remain virtual

I want to go to the office for sessions

A mix of the above

Availability

Please update on your availability for scheduling

Updates

Please provide any updated information that would be helpful for me to know,

Additional information

Please include any other information you feel is important for me to know.

Emergency

I understand that if I am having thoughts of harming myself or others that I need to call 911 or go to my nearest emergency room. This form is not a consent nor a guarantee for treatment.

Yes, I understand