Appointment Request

To schedule an individual, children, couples, marriage, or family therapy appointment or to obtain additional information about any of these counseling services, please fill out the form* below or give us a call at 262-266-0222 .

*Please make sure to indicate the name of the insurance company you wish to use for your visits, this will be helpful for matching you with a clinician.

We are committed to your privacy. Do not include confidential or private information regarding your health condition in this form or any other form found on this website. This form is for general questions or messages to the practitioner.

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Helpful Forms

Click here to view and print forms for your appointment.

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