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Name *

First Name

Last Name

Contact preference *

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Email

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Phone *

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Voicemail consent

If you prefer phone calls, is it ok for me to leave a voicemail?

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How did you find me? *

Referral

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Psychology Today

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Notices *

I understand that submission of this form and any resulting consultation communication with Tree Top Therapy Services PLLC does not in itself initiate a therapeutic relationship between myself and Tree Top Therapy Services PLLC. I understand this form is not intended to address time-sensitive matters or to receive immediate emergency support.

Telehealth *

I understand that all services are currently held online.

I understand that Tree Top Therapy Services, PLLC does not currently take insurance. *

It may be possible to submit directly for reimbursement through your insurance. Contact them directly for out of network options and specifically mention working with an associate-level provider.