Work Together — Mountain Laurel Counseling

let’s work together.

Thank you for your interest in working together. This form is the first step in establishing an effective therapeutic relationship, and will help us both determine whether it makes sense to move forward, together. I will reach out to you soon after your submission. If it feels right, we can schedule a first session and experience working together and decide whether to move forward.

Name

First Name

Last Name

Phone

(###)

###

####

Age

In just a sentence or two, why are you seeking therapy at this time? No need to go into detail, here-- once we schedule a first appointment, I will send a more thorough intake form, and we will have as much time as we need to explore these themes and problems in depth when our work begins.

If you have insurance you want to use, please choose your plan below.

These are all the types of insurance I accept.

I schedule appointments between 8:30am and 3pm on Mondays, Tuesdays, Thursdays, and alternating Wednesdays.

I understand; that works for me.

My office is located at 1293 Hendersonville Road in Asheville, near Carolina Day School and Fresh Market. I am on the second floor, and there is no elevator. To meet in person, you will need to be able to climb one flight of stairs.

I understand; that works for me.

I need or want to meet virtually.

Please share any questions you have, or anything else that feels important for me to know at this initial stage.

let’s work together.

Location

Contact