Appointment Request
Your Goals for Counseling
Preferred Clinician
Name: First and Last*
Email*
Preferred days/times for appointment
Phone
Briefly, what would you like to work on during therapy?
Cheryl Hughes, LCSW, CSW-G
Kim Hiott, LPC
Sareena Miduski, LPC
Natasha Ramsey PsyD, LPC, NCC, CCTP
Cathy Sutton, LCSW
Jon Hester, LCSW