Let’s Connect

Please fill out this form to schedule your free 20 minute consultation. Or for any questions or inquiries. I look forward to connecting!

I reserve the right to be unresponsive to any inappropriate communication.

Name

First Name

Last Name

Email Address

Phone

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Subject

Tell me about yourself and your reason for reaching out at this time

Form Submission Agreement

I understand that this form is for general inquiries and scheduling purposes only. If I am experiencing an emergency, I will call the mental health crisis hotline at (512) 472 4357.

Office Address

Authentic Self Austin

2208 E 14th Street

Austin, TX 78702

The black and white house on the north west corner of E 14th and Chestnut Ave. We are ADA accessible.