New Client STEP 1 : Download and fill out consent formSTEP 2 : Scroll down and complete Intake form Download Here Date of Birth * First Name Last Name Email * Phone (###) ### #### Date of Birth * MM DD YYYY City Charlotte - Mecklenburg Other Emergency Contact Select ALL that apply I currently take medication(s) for my mental health I have been diagnosed before Alcohol Use Nicotine Use Marijuana Use I have a history of self harm I am currently under court supervision ie. probation, domestic relations, legal issues You will receive a confirmation email upon receipt. Thank you for filling out the forms before your scheduled session. Download Here Download Here Intake Form