Hi, we’d love to hear from you! Please enable JavaScript in your browser to complete this form.Name and Age (if under 18) of Potential ClientYour Name *FirstLastCity of ResidenceEmail *Phone Number *Preferred Therapist?First AvailableKennedyMarcus ChristinaTaraEmmyMeganEricTsvetaJenya (telehealth only)LindseyWere you referred by a physician? If so, please provide name:Video Session, In Person Session, or First Available? Comment or Message: *Help Is On The Way! Yes, please......I'd like to receive Loyal Blue's email newsletter which contains skills, info on what’s working in counseling, and tips to lead a happier and healthier life. (We won't share your information.) This form is secure and all information is encrypted. We take your privacy seriously. Submit
