Name *

First Name

Last Name

Phone

(###)

###

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Preferred Location

Preferred Location

In-person/Temecula Office

Online Video

First available

Availability Inquiry *

Sessions are conducted between 9 AM and 3 PM, Monday through Friday. The latest appointment available each day starts at 3 PM, unless otherwise arranged in advance. Please confirm your availability during these hours.

Yes

No

Fee Disclosure *

I am an out of network provider. The fee for a 50-minute individual session is $180. Please confirm your acknowledgment. Use the free insurance benefit check tool below for your out-of-network coverage.

I acknowledge

How did you find me? *

Referral source

Friend or Family Member

Social Media

Internet Search

Chat GPT Search

Other