New Client Intake

New Clients, Please Note:
Submitting the form below does not automatically guarantee an immediate appointment. Typically clients book their own appointments online as the schedule allows and there is a waitlist feature available on the scheduling site that allows you to expedite your request if availability is limited. If you would like to be contacted about scheduling, please either indicate this at the bottom of this form or send a separate email inquiry. Please include your day/ time availability.

I understand that this questionnaire is a general information gathering intake, and does not replace the initial intake at EWTA. I understand it will be submitted through an unencrypted portal. I will only share personal information that I am comfortable sharing in an unencrypted format. *

I understand and agree

welcome!

Solidarity Avowal & Resources