New Clients - True North Therapy

Scott is available for new adult clients.

Brian has limited availability for private pay adult clients.

We are unable to accommodate marital/couples counseling requests.

Name of Person Completing Form *

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Prospective Client's Legal Name *

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Prospective Client's Date of Birth *

Email Address for Contact *

Confirm Email

Phone Number for Contact *

How May We Contact You? *

Prospective New Client for *

Health Insurance Company (or Self-Pay) *

Prospective Client's Scheduling Availability *

Briefly Describe Your Current Concerns *

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