Let’s get started.

This form is here to help me get to know your needs — no pressure to have the ‘right’ answers. Share as much or as little as you’d like.

We’ll chat, get a feel for things, and figure out together if we’re a good fit.

Complete this form and I’ll be back in touch within 1 business day.

Name (whatever you go by)

First Name

Last Name

Email

Phone

(###)

###

####

How do you prefer to be contacted to schedule our consultation?

What is the best time of day to reach you?

Are you considering in-person or virtual therapy?

What days and times tend to feel most manageable or supportive for you to attend regular therapy sessions?

What kind of support are you looking for?

What feels heaviest or most important right now?

No pressure to be deep or eloquent—just start with whatever’s been making you want to scream, cry, or fantasize about a solo vacation.

Accessibility preferences or neuro needs I should be aware of?

(e.g., video off, slower pacing, reminders, sensory stuff)

Do you plan to use insurance or prefer private pay?

Feel free to just list your insurance company, or type “private pay” if that’s your preference. No pressure — this just helps me guide you better.

Is there anything else you'd like to share with me prior to our conversation?

Note: Please do not include Personal Health Information in this form.

Call or Text

248.266.1503

Email

tcassady@mindful-therapeutics.com

office location

Virtual throughout Michigan

In-person: Troy, Michigan

Coming Soon: Virtual therapy in Florida & Illinois