Please note that if you are a current client, you do not need to fill out this form. Go ahead and head straight to the Patient Portal. 

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P.S. Although I make every effort to promptly address and respond to these inquiries, it's important to understand that this method of contact is not suitable for emergencies. In the event of a mental health emergency or if you are experiencing thoughts of self-harm or harm to others, I strongly advise you to immediately dial 911 or seek immediate assistance at the nearest hospital. Your safety and well-being is my utmost concern.