Name *

First Name

Last Name

Phone Number *

Country

(###)

###

####

I'm interested in... *

choose all that apply

Consulta en español

Individual Relationship Counseling

Dance/Movement Therapy

Therapeutic Couples Dance

Therapeutic Wedding Dance

Couples Workshops

Couples Counseling (SPOTS FULL)

Premarital Counseling (SPOTS FULL)

Type of call *

Phone

Video

This is a private pay practice and insurance is not accepted. I have read the FAQ's and understand that the fee is $195.00, paid at time of service. I will receive a Superbill if using my out-of-network benefits. I can easily submit my claims for out-of-network health insurance reimbursement from Reimbursify. The first claim is free- courtesy of this practice. *

Yes, I understand.

All counseling and dance therapy sessions for clients in Chicago, IL., are currently offered online. The Chicago location for the Therapeutic Couples Dance and Therapeutic Wedding Dance services will be determined at booking. *

Yes, I understand.