Request an Appointment Name * First Name Last Name Email * Is it okay to email you? * Yes No Phone (###) ### #### Is it okay to call you? * Yes No I'm interested in... * Individual Therapy Couples/Family Therapy Consultation Public Presentation/Training Other What insurance do you plan to use? Additional Information Tell us what you are looking for and any preferences you might have. Thank you! We will follow up with you within 3 business days. If you are in need of immediate support, call Resolve at 888-796-8226