Appointment

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I understand and agree to the Terms and Conditions.

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Name *

First

Last

Email *

Text *

Video Phone (via VRS)

Optional

Select Your Specialist *

Advocator
Mental Health Counselor
Administrator

Type of Appointment *

In-Person Appointment
Online Meeting

Select your preferred appointment type: In-Person for a face-to-face meeting or Online Meeting for a virtual session from anywhere.

Specialist Agreement the

Select Appointment Location

In-person appointments are available at two locations only.

Specifically Requested Date & Time *

Date

Time

Requests must be made 24 hours in advance to avoid scheduling conflicts.

If the Date Is Unavailable *

If your date is unavailable, we will check ahead and offer alternative options.

If the Time Is Unavailable *

If your requested time is unavailable, we will suggest available times that best match your preferences.

File Upload

Drag & Drop Files, Choose Files to Upload You can upload up to 3 files.

Please do not upload SENSITIVE INFORMATION such as BANK DETAILS, PERSONAL FINANCIAL DOCUMENTS, or anything unrelated to your appointment or technical issues. Only upload DOCUMENTS like SCREENSHOTS or FILES that are directly related to your appointment.

Message Regarding the Appointment *

Confirm the Agreement *

I confirm my information is correct and I agree to the Terms and Conditions.

Confirm that your information is correct and you agree to our Terms and Conditions before submitting.

Appointment

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