You may request an appointment with a therapist / counselor or coach at Restoring Hope Counseling & Coaching for an individual or couple or to obtain additional information about any of these or other counseling, coaching, or consulting services, by completing the form below or giving us a call. We look forward to working with you!

We are committed to your privacy. Do not include confidential or private information regarding your health condition in this form or any other form found on this website. This form is for general questions or messages to the practitioner.

Name

First Name

Last Name

Phone

(###)

###

####

Email

Preferred Date & Time

Choose Therapist/Psychiatrist

Please choose from the list below

Message

Request An Appointment