Have a Billing Question? "*" indicates required fields Name* First Last Email* Enter Email Confirm Email Do You Have Insurance?* Yes No Insurance Provider Therapist Name Message*Please use this form for general questions or appointment inquiries only. For your privacy, please do not include sensitive personal or medical information. This form is not monitored for urgent or emergency situations. If you are in crisis, call 911 or 988 immediately. Submitting this form does not establish a therapist-client relationship.CAPTCHANameThis field is for validation purposes and should be left unchanged. Our Location in South Austin 3109 W Slaughter Ln Ste C Austin, TX 78748 Get Directions Call 512-200-2529
