We're glad that you have chosen Kin-Etic Behavioral Health for your mental health journey! Please complete this form to help us get to know you better. If you are seeking services for couples or marriage counseling, please click here. For all other services, please complete the form below. 

Before completing the form below, please note the following:

• We do not accept appointments through Employment Assistance Program (EAP).

• All appointments are held virtually (via video or phone) until further notice.

• If you are seeking services and your deductible has not been met, you will be charged your insurer's contracted rate.

• If you are seeking services out-of-pocket, please click here to view our fees.

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Once your information is received, our office will contact you within 1-2 business days to schedule an appointment.