Fill out the form below to request an appointment.

First Name

Email Address

Phone Number

Partner's first name (Optional)

About You

Please provide a brief description of your reasons for requesting couple therapy.

Weekly Availability

Please select the best days for you and your partner to attend sessions.

Monday

Tuesday

Wednesday

Thursday

Friday

Saturday (mornings)

Session Time Availability

Please select all times you are available

Morning (9am-12 noon)

Afternoon (12-5 pm)

Evening (5-9 pm)

Your Preferred Therapist

Please choose your preferred therapist, if you have a preference.

Other Details

If there's any additional insight you'd like to provide us, please include it below.

Our office hours are: Monday - Friday | 9:00 am -5:00 pm Eastern/US

Therapy sessions are offered:

Monday - Friday | 9 am - 9 pm Eastern/US

Saturday mornings | 9:00 am - 1:00 pm Eastern/US

Call us, toll free: (833) 444 - 9446