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TAKE THE FIRST STEP TOWARD HEALING!

Please complete the information below and we will respond within 24 hours with a therapist recommendation that matches your needs.

Our areas of interest include: (check all that apply)
We prefer a therapist who is:
Where do you reside? (this impacts whether you are matched with a couples therapist or a couples coach).
Our fee per 50 minute session varies based on life experience, clinical experience, training, education (master's, doctorate), and special certifications. Please indicate the fee you are able to pay and we will do our best to match you with the appropriate professional.
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Information shared on this intake form may be viewed by members of the Couples Recovery Center staff in order to match you with the therapist who is the best fit for you. 

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By entering your information, you will be added to our mailing list however you will be given the option to unsubscribe at any time.  

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