Appointment Request

 

• Please submit this form if you would like to make an appointment

• We  offer services based on a sliding scale of $135 - 250/hour depending on household income.

• We are credentialed with:

  • Medi-Cal/Alliance

  • CCAH

  • AETNA

• As a Licensed Marriage and Family Therapist credentialed with Aetna, we offer secure, HIPAA-compliant telehealth sessions for clients outside our immediate area.​

• We also accept out-of-pocket payment (we can provide a Superbill and an electronic submission option)​

• Please indicate your Insurance & ID Number or other Method of Payment in the Client Preferences text box at the bottom of this form.​