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Please use the form linked below to initiate the process of requesting therapy services with the Psychotherapy Cooperative. The process involves several steps, and submitting the form is not a guarantee of receiving an intake or therapy services through the Psychotherapy Cooperative.

 

The information you submit will enable the Psychotherapy Cooperative to determine whether you are eligible for our services. You will receive a reply from us within 72 business hours of your submission. If you are eligible, we will send you a link to an online intake form that will help us evaluate whether the Psychotherapy Cooperative is the right fit for your needs.

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It is possible that the Psychotherapy Cooperative will not have a therapist available to meet with you immediately. In this case, you may be placed on a wait list after completing the intake process.

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By submitting information through our intake request form you are consenting to the associated risks of sharing information via the internet, including interception by a third party and disclosure under public records laws. While the Psychotherapy Cooperative uses a HIPAA-compliant service for email and the intake request form, we cannot guarantee confidentiality or security of information sent via the internet.

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INTAKE REQUEST FORM