Wonder Counseling & Consulting

Who would be receiving care?

My partner and me

Your info

First name

Last name

Phone

Name you go by

Date of birth

State

Select the state you live in

How would you like me to contact you, through email or phone?

Administrative

What are you looking for today?

Client Preferences

What are the main issues or goals you’d like to focus on in therapy?

For example: what you'd like to focus on, what feels most important for me to know about what you’re hoping to address in therapy, etc.

Limited to 600 characters

If you or others are in immediate danger or experiencing a medical emergency, call 911 immediately.

By submitting this form, you agree to the processing of your sensitive personal information, which may include protected health information (PHI). This information may be viewed by team members in this practice.