GET IN TOUCH

Name *

First Name

Last Name

Phone *

(###)

###

####

Contact preference *

Do you prefer me to respond to your inquiry via phone or email?

Phone

Email

If you prefer phone, may we leave a voicemail at the number you provided? *

Yes

No

NA

Which therapist would you like to work with?

Dr. Natalie (virtual and private pay only; accepting limited new clients)

Meghan Malloy, M.A. (limited in-person; on waitlist)

Jennie Dopf, M.A. (virtual only; accepting new clients)

How do you want to work together? *

Let me know your main reason for reaching out to me

Individual therapy

EFT therapy for couples

Somatic experiencing and/or trauma focused work

Supervision or consultation

Therapy for adolescents/teens

Process group therapy for women (get added to the waitlist)

Media or speaking engagement

Other (please explain below)

How did you hear about us?

Google search

Psychology Today

ICEEFT Therapist Directory

Friend/colleague (if you were referred by another therapist or doctor, please let me know who referred you in the text box below)

Other