Register

Registration is only required if you do not have a username. Please check your spam & junk mail folders to ensure you have not already received an email with a username and password. If you already have a username log in here

Each account must have a unique email address associated with it. Please contact us if you need multiple accounts with the same email address (i.e. related family members).

Please register here as a new client! You will be asked to complete the initial paperwork, add your billing information, and then you will be able to pick your first initial intake assessment appointment (80 minutes). We look forward to helping you!

Counselor

Client Information

/ Middle Initial

( optional )
 
( for Text Message Reminders )


Emergency Contact

First Name
Last Name
Phone
Mobile
Relation
Email

Log in Details

( If client is a minor, the legal guardian must enter their email address below. )



Between 8 and 40 letters and numbers