Get started with therapy today!

If you are interested in starting therapy, please complete the form below.

We look forward to hearing from you.

First Name

Last Name

Age of Client

If You Are Completing This Form For A Minor Please Provide Your Name And Your Relationship To The Minor.

Phone

Best days/times for appointments:

Please send a brief and general message about what you are looking to work on in therapy.

By submitting this form via this web portal, you acknowledge and accept the risks of communicating your health information via this unencrypted email and electronic messaging and wish to continue despite those risks. By clicking the Send button below you agree to hold CA FAMILY THERAPY INC harmless for unauthorized use, disclosure, or access of your protected health information sent via this electronic means.

Thank you for reaching out!