Be Here Now, EMDR & Holistic Counseling

Be Here Now, EMDR & Holistic Counseling Send Message

Who would be receiving care?

My partner and me

Someone else

Your info

First name

Last name

Phone

Name you go by

State

Select the state you live in

Reason for care

What are you primarily seeking support with?

What prompted you to reach out at this particular time?

Trauma or difficult past experiences Repeating emotional or relational patterns Anxiety, overwhelm, or difficulty regulating emotions Grief, loss, or major life transition Relationship or attachment concerns Depression, disconnection, or feeling stuck Focused EMDR or trauma processing Couples or relationship therapy General support / ongoing psychotherapy I'm not sure yet Other

What kind of care are you interested in exploring?

It's okay if you're unsure. Treatment recommendations are individualized after consultation and assessment.

Ongoing individual psychotherapy Focused trauma or EMDR therapy Individual intensive therapy Couples therapy or couples intensive I'm not sure — I'd like help determining what may be appropriate Other

Are you currently working with another therapist?

This helps us understand whether you're seeking primary therapy or focused work alongside an existing therapist.

Administrative

What can we help you with?

Choose the option that best describes what you need from us right now.

Referral source

How did you hear about Be Here Now?

Client Preferences

Preferred appointment times

Morning Afternoon Evening Weekend

Preferred clinician

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Preferred modality

For medical emergencies, contact your healthcare provider or call 911. For mental health crises, call or text 988.

By submitting this form, you agree to the processing of your sensitive personal information, which may include protected health information (PHI). This information may be viewed by team members in this practice. You also agree not to submit any payment information, including credit or debit card details, through this form.