Appointment Request

To schedule an individual, children, couples, marriage or family therapy appointment, or to obtain additional information about any of these counseling services, please fill out the form below or give us a call at 336-945-0137 today.

We are committed to your privacy. Do not include confidential or private information regarding your health condition in this form or any other form found on this website.This form is for general questions or messages to the practitioner.