If you are completing the self-referral please fill out the below information and we will reach out to you right away.

  • Please fill out your information in the form below to self-refer for therapy. Someone from our outreach team will contact you within one week to complete an intake process over the phone. 
  • There is no cost to you for therapy, thanks to our funders and generous donors.
  • We ask clients to commit to a minimum of 4 months (16 sessions) of therapy; you can discuss this more with your therapist in the first session. 
  • Talk therapy is not always a good fit for some of our clients. If it’s determined that a different type of therapy would suit you better, our outreach team will help connect you to other services that meet your needs.