If this is a mental health emergency, please click here.

To schedule an appointment please contact our scheduling specialist or fill out the form below. 

Scheduling Specialist

Sandy Chalkwater
(216) 223-8773

Please specify preferred appointment days:

Please specify preferred appointment times:

Preferred Office Location:

Please specify what type of counseling you are seeking:

Please select if you are willing to work with an emerging practitioner (an intern):

Please select if you are comfortable with an emerging practitioner (an intern) observing your session:

Have you ever been treated for any mental illness? Such as by a psychiatrist, general practitioner, or other counselor/therapist:

Have you been recently hospitalized for a psychiatric issue?:

Are you currently experiencing suicidal thoughts or have had any in the past 6 months?:

Are you currently experiencing thoughts or urges to harm yourself or others? Have you had thoughts or urges in the past 6 months?:

Are you an Ohio resident/physically in the state of Ohio during appointments?: