Contact Us

Welcome, let’s get started here. Simply fill out the form below and we will be in touch with you shortly.

We’ll verify your coverage within one business day after receiving your info so you don’t have any hidden fees or surprises.

If you don't receive a confirmation email of your submission or are looking for a same day appointment or if you don't hear from us within 1 business day, please call us at 443-681-9150.

Fields marked with an * are required

Client's Full Name *

Phone

Email *

Message *

If this is regarding scheduling an appointment please fill out the below information:

Date of Birth

Client is under 18

Parent's Names *

Parent's Phone Numbers *

Address

City

State

Zip

Insurance Carrier

If Other

Member ID

Group Number

Provider Claims Number

Out of State?

Referred by

Therapist Gender Preference

Is there a specific therapist whom you would like to see?

Seeking

Individual Therapy

Couples Therapy

Parenting Skills

Anger Management

Other

If Other

Preferred day(s) to be seen

Sunday

Monday

Tuesday

Wednesday

Thursday

Friday

Preferred time

Morning (8am-10am)

Late Morning (10am-12pm)

Early Afternoon (12pm-3pm)

Afternoon (3pm-5pm)

Evening (5pm-8pm, limited availability, please check one additional time)

Questions or comments/ When would you like to start? Any specific issues you are seeking help with?

Please note: If you did not receive an instant email confirmation or do not hear back from us within one business day, please call us at 443–681–9150.