Name * First Name Last Name Email * Phone * (###) ### #### Reason for Contact 10 Minute phone consultation Waiting List / Cancelation List Student Somatic Experiencing Session What are you hoping to achieve through our work together in therapy? * Acknowledgement I do not accept insurance Cash Pay ($155/ 55 Minute $235/85 Minute) Sessions In Person Televideo How did you find me? Professional Referral Google Social Media Friend Family Somatic Experiencing International Directory Other Thank you! Please note return communication may be returned 24 to 72 hours.
