Let’s connect. Name * First Name Last Name Pronouns * Email * What days/times are you available for a 15-minute phone consultation? * If outside of PST, please note your timezone. Interested in: * Individual Therapy ADHD + Autism Assessment Professional Consultation I am a private pay practice. Are you looking to pay out of pocket, use insurance, and/or utilize a superbill? * Out of pocket Superbill Insurance As much as you feel comfortable, please share a bit about what you're looking for support with. * Please note: this form is not HIPAA-protected. Please only share brief details. Thank you! Please expect to hear back from me by email within 72 business hours. —Ashleigh
