Individual Therapy

Name *

First Name

Last Name

Date of Birth *

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Phone *

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I'm reaching out for consultation.

15 minutes free phone consultation.

I'm seeking support with...

Basically, what brings you here today?

Feeling stuck.

Where do I fit?

Struggling with making meaning.

Repeated patterns.

Struggling with affirmation & validation.

Bullying (e.g., workplace, school, home).

Growth & Healing.

Racial distress.

Religious distress.

Childhood trauma.

Struggling with shame.

Struggling with anger.

Displacement distress (e.g., I am a newcomer).

Navigating/exploring gender expression.

Navigating/exploring gender and/or sexual identity.

Navigating/questioning/exploring medical transition (e.g., sex affirming choices/procedures).

Conversion Therapy/Sexual Orientation and Gender Identity and Expression Change Efforts (SOGIECE) Survivor.

Navigating relationships.

Cultivating/navigating healthy boundaries with parent/s, family member/s, friend/s, coworker/s, etc.

Navigating loss and grief.

Navigating anticipatory loss and grief.

Not listed above, please read my message below.

Privacy and Security *

I understand that communications via email over the internet are not secure. Although unlikely, I understand that there is a possibility that an unintended party could intercept and read the contents of an email. I also give Just Healing Psychotherapy permission to leave a message at the phone number and email address provided.