Name(Required) First Last Initial Email(Required) Confirmations will be sentPhone(Required)Used to schedule consultationsWhich state do you live in? (Required due to State Licensing Laws)(Required)VirginiaCaliforniaDistrict of Columbia (DC)FloridaMarylandNorth CarolinaSouth CarolinaWest VirginiaWhich services are you interested in?(Required) Couples Counseling Individual Partner Counseling Pre-Marital Counseling Something Else What is your preferred venue?(Required) In-Person Only Virtual Sessions Only Either Which office location in VA do you prefer?(Required) Alexandria Arlington Charlottesville Fairfax Leesburg McLean Reston Short Pump Doesn't Matter (virtual only) Which office location in MD do you prefer?(Required) Bethesda Columbia Frederick Rockville Doesn't Matter (virtual only) Which office location in NC do you prefer?(Required) Cary Charlotte Wilmington Doesn't Matter (virtual only) Which office location in DC do you prefer?(Required) Dupont Circle Doesn't Matter (virtual only) Which office location in FL do you prefer?(Required) Winter Park Doesn't Matter (virtual only) Which office location in SC do you prefer?(Required) Charleston Mt. Pleasant Doesn't Matter (virtual only) Which office location in CA do you prefer?(Required) Los Angeles Pasadena Doesn't Matter (virtual only) Which office location do you prefer for West Virginia Residents(Required) Leesburg Frederick (Telehealth is not available for West Virginia residents)Therapist Preference?(Required)First Available (Preferred)Specific TherapistSpecific Therapist Alexandria(Required)Alex Honigman (virtual only)Gabrielle FancherYasir Ahmed (virtual only)Specific Therapist Arlington(Required)Holly WillardSpecific Therapist Charlottesville(Required)Glen DenlingerSpecific Therapist Fairfax(Required)Gabrielle FancherHeidi LindorfKelly WalkerDr. Martha RacketsMary BakerMichael BorashDr. Paul BirchQuintin TalleyRebecca KassabianRebecca StevensonValerie PattonGlen Denlinger (virtual only)Yasir Ahmed (virtual only)Specific Therapist Leesburg(Required)Mary Rainer-SkalaSharon HamiltonSpecific Therapist McLean(Required)Holly WillardSpecific Therapist Reston(Required)Elizabeth StevensSpecific Therapist Short Pump(Required)Michael FronceVictoria IpsenSpecific Therapist VA Virtual Only(Required)Alex HonigmanChristy Van HornElizabeth StevensGabrielle FancherGlen DenlingerHeidi LindorfHolly WillardJennifer GoodrichKelly WalkerMarissa JosiahDr. Martha RacketsMary BakerMary Rainer-SkalaMichael BorashMichael FronceDr. Paul BirchQuintin TalleyRebecca KassabianRebecca StevensonSharon HamiltonValerie PattonVictoria IpsenYasir AhmedSpecific Therapist Washington DC(Required)Alex Honigman (virtual only)Marissa Josiah (virtual only)Quintin Talley (virtual only)Yasir Ahmed (virtual only)Specific Therapist DC Virtual Only(Required)Alex HonigmanHolly WillardMarissa JosiahQuintin TalleyYasir AhmedSpecific Therapist Bethesda(Required)Christy Van HornEllen SingerMarissa JosiahQuintin TalleyYasir Ahmed (virtual only)Specific Therapist Columbia(Required)Ellen SingerMarissa JosiahSpecific Therapist Frederick(Required)Jessica CoreyLisa LavittSpecific Therapist Rockville(Required)Christy Van HornEllen SingerQuintin TalleySpecific Therapist MD Virtual Only(Required)Alex HonigmanChae KwakChristy Van HornEllen SingerJessica CoreyLisa LavittMarissa JosiahMegan GregoryQuintin TalleyYasir AhmedSpecific Therapist Cary(Required)Nicole StoneSpecific Therapist Charlotte(Required)Erin ThompsonSpecific Therapist Wilmington(Required)Chae KwakMegan GregorySpecific Therapist NC Virtual Only(Required)Chae KwakErin ThompsonMegan GregorySpecific Therapist Charleston(Required)Elizabeth SartoriErin Thompson (virtual only)Specific Therapist Mt. Plesant(Required)Elizabeth SartoriErin Thompson (virtual only)Specific Therapist SC Virtual Only(Required)Elizabeth SartoriErin ThompsonSpecific Therapist Winter Park(Required)Glen Denlinger (virtual only)Valerie Patton (virtual only)Specific Therapist FL Virtual Only(Required)Glen DenlingerValerie PattonSpecific Therapist for WV resident (Leesburg office)(Required)Mary Rainer-SkalaSharon HamiltonSpecific Therapist for WV resident (Frederick office)(Required)Jessica CoreyLisa LavittSpecific Therapist Los Angeles(Required)Sara LoughlinAlex Honigman (virtual only)Specific Therapist Pasadena(Required)Sara LoughlinAlex Honigman (virtual only)Specific Therapist CA Virtual Only(Required)Sara LoughlinAlex HonigmanAre you aware we are NOT "in-network" with health insurance companies and you will pay out-of-pocket for our services?(Required) Yes, I understand I will pay out-of-pocket and some reimbursement may or may not be possible (required to finish form) No, I'd like to learn more about your fees & insurance reimbursement policy Please click here to visit our fees and insurance page. This should help answer your questions about costs and reimbursement options. Knowing that we do not accept in-network insurance is required before scheduling or talking with someone. Relational Wellness Yes, when you get time to write "relational wellness" blog posts send them to me (just not too many) Δ