Request an Appointment

To request an appointment for an Initial Evaluation Session, please fill out the form below to send us an email. We respond to inquiries within 24-48 hours on weekdays, Monday through Friday, from 9 am to 12 noon unless it is a holiday.

Name*

Phone*

Email*

Address*

City and Zip Code*

Which office are you interested in?
Silicon Valley (check box)
Sacramento Valley (check box)
California Video Therapy (check box)

What problem(s) are you seeking help for?*

Please provide a brief description of the problem(s):*

Is your schedule flexible or do you need specific days and hours?*

Are you open to seeing any therapist at our center or do you have a request for a specific therapist?*

Note: We often have a waiting list for specific times and therapists. The more flexible you are, the sooner we will be able to accommodate your request for an appointment.

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