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Blue Mountains
Blue Mountains

Appointment Request

To obtain additional information about any of these services, please fill out the the form below and include what insurance you hope to use.   To schedule an appointment please fill out  fill out the intake forms and send them to me.  Once I have received the intake forms I will contact you about an appointment time. 

Please note: I do not accept clients who wish to schedule occassionally.  Working on issues requires a weekly committment (usually booked one month at a time) and my scheduling does not allow for intermittent appointments.  In addition, I do not accept referrals for medication issues only.   Please contact a psychiatrist for that. Thank you for your understanding.

We are committed to your privacy. Do not include confidential or private information regarding your health condition in this form or any other form found on this website. This form is for general questions or messages to the practitioner.

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By clicking send you agree that the phone number you provided may be used to contact you (including autodialed or pre-recorded calls). Consent is not a condition of purchase.

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