If you have determined distance counseling is a good fit for you here are the next steps to follow. Please note when you submit the following forms they will be sent via an encrypted system for your privacy protection.
Also, if you pay for services here in advance and I determine you are not a good fit for online counseling with me after reviewing your intake form your fee will immediately be refunded along with an encrypted explanation and appropriate referral.
STEP 1: Review the Consent Form
Please review carefully and sign this Online Consent Form.
STEP 2: Complete the Intake Form
Please fill out the Intake Form and click SUBMIT.
STEP 3: Select and Pre-pay for Service
Decide which service you’d like to pay for and complete the secure payment transaction. After the payment has been completed, you will be returned to this page where you can complete the next steps.
PLEASE NOTE: Video counseling is the same fee as phone counseling. If you prefer video counseling via a HIPAA compliant platform, please select phone counseling from the menu below but send a message via our contact form notifying us you prefer distance counseling.
If registering for email counseling …. Set up your Hushmail email account
Go to www.hushmail.com and set up a free account. Send an email from that account to me at firstname.lastname@example.org requesting services. Hushmail.com offers an encrypted system of email exchange.