Please complete the following form to indicate your needs and preferences. Upon submission, our staff will contact you within one business day to discuss our availability and options available to you. Name* First Last Phone Number*Email Address* Mailing Address* Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Preferred Office Location*Please SelectArvadaAuroraBoulderBroomfieldCastle RockCentennialDenverEvergreenHighlands RanchLafayetteLakewoodLongmontLouisvilleGoldenNorthglennThorntonWestminsterWheat RidgeWinter ParkAge of Client(s)*Why are your seeking counseling?*I'm Interested In:*Please select all that apply. Synergetic Play Therapy Theraplay EMDR Somatic Experiencing Animal-Assisted Therapy Equine Therapy Art Therapy Music Therapy Yoga Therapy Hakomi Emotionally Focused Therapy PACT Attachment-Based Family Therapy Help Me Find the Best Service for My Needs I'm Looking For:*Please select all that apply. Individual Therapy Couples Therapy Family Therapy What can you afford?*Please select the cost of services you can afford.Please Select$30$60$90$120Preferred Therapist*Match me with a suggested TherapistI would like to choose my own TherapistChoose Your Preferred Therapist*Please select your preferred therapist.Select a TherapistAdrian Lobb, MA InternAdria Rigg, LPC, LMFTAdria Rigg, LPC, LMFTAllison Bratsch, MA, LPCBeth R Teeters, LMFTBrittany Stewart, MA, MFTCBrittany Wingfield, MS, LPCCatherine Mathon, Registered PsychotherapistPolly Douglass, LPCErin Henry, LCSWHeidi Knapp, MA InternJacquelyn Girdlestone, LPC RYTJenna CorriveauJessica KimakKari Baker, MA, LPCCKelly Miller, LCSW, RPTSKelly Smyth-Dent, LSW, MSW, MAKristen Chamberlain, LCSW, RYTKristen Sandine, MA, NCC, LPCCLauren Stokes, MA, LPC, MFTCMaggie Phillips, MFTCNissa Jackman MA, LMFT, ATRTaylor Hyman, MA InternNot sure who to choose? View our Therapist Directory.Terms of Service*I Agree" By clicking the box, I agree to the terms and conditions for use of this site, as amended from time to time. Additionally, I specifically request the Company to contact me through my provided email regarding services, scheduling, billing, and all other related matters. I acknowledge and agree that by agreeing to be so contacted, I waive any claims I may have against the Company for unwanted solicitation or contact. I also understand that these communications are not secured, may be intercepted or otherwise read, and are not ensured to protect the confidentiality of your name, email address, or other information that may be otherwise confidential. I further understand that I may opt out of further contact by the Company by requesting in writing a removal from all contact lists. "EmailThis field is for validation purposes and should be left unchanged. This iframe contains the logic required to handle Ajax powered Gravity Forms.