Contact Me Change is not always easy, and yet, here you are showing up for yourself. As we get ready for our phone consultation, please complete the below form. This allows me to better understand how I can support your needs. Name * First Name Last Name Email * Phone * (###) ### #### Are you aware that Rooted Minds Counseling & Consulting does not insurance * Yes Before you schedule * Are you currently a resident of Maryland and/or intend to physically be in the state of Maryland during scheduled sessions? Are you currently a resident of Florida and seeking telehealth only services.? Have you reviewed my service fees page and are aware that Rooted Minds Counseling & Consulting does NOT accept insurance? You can be provided a superbill to submit to your insurance provider to seek potential out-of-network reimbursement if eligible. How did you hear about Rooted Minds Counseling & Consulting? What service are you interested in? * Individual Therapy Relational Therapy Sex Therapy Professional Services Consultation Date * Consultations are ONLY scheduled on Wednesday's (5:15 pm to 8:00 pm) Friday's (1:15 pm to 5:15 pm) MM DD YYYY Best time to contact you * Hour Minute Second AM PM Message * Thank you for your outreach! I do my best to return to all messages 24 - 48 hours once received.
