Contact Me for Therapy, consultations, Speaking, or Trainings

Name

First Name

Last Name

How did you hear about me?

What are you interested in?

Individual Therapy

Trainings & Speaking

Clinical Consultation for Providers

Other

Tell me a bit about yourself and your needs.

Please fill out the form to inquire about therapy services, speaking, or clinical consultations.

Modern Mind & Heart is licensed to provide services within the state of Illinois only. If you are in crisis or need immediate assistance, this form is not the appropriate avenue to get help. Please call 911 or go to your local emergency room if your safety is at risk.