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Client Form

Please Fill Out This Form Before Your Free Phone Consultation!

Thank you for filling out our contact form. Prior to your free phone consultation, please fill out the form below so that we can begin our process of determining the best therapist to meet your needs.
Client Form
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Name

What type of service are you interested in? 

Do you have a preference for which therapist you would like to work with?
For more information about our therapists, please see our therapists bios. Please note that we cannot guarantee therapist availability but will do our best to connect you with a therapist that will be the overall best fit for your needs. Check all therapists you are interested in.

Please select your preference for the location of your potential therapy.
Please check all locations that are feasible for you.

What is your availability for your free consultation call?
For relationship or couples therapy, we suggest

How did you learn about us?

How did you hear about us?
Policy Confirmation
DCST does not accept insurance and is a private pay practice. Additionally, we are unable to work with clients who live outside of Colorado or who have Medicaid due to state and federal laws. Please check to confirm you understand and accept the above policies.