Name *

First Name

Last Name

Phone Number

You agree to receive informational messages (appointment reminders, account notifications, etc.) from Gentle Healing Space. Message frequency varies. Message and data rates may apply. For help, reply HELP or email us at admin@gentlehealingspace.com. You can opt out at any time by replying STOP.

(###)

###

####

I am interested in services for: *

Select all that apply

Anxiety

Depression

Work Stress

Relationship Problems

PTSD

OCD

ADHD/ASD

Parenting

Childhood Trauma

Military Trauma

Panic Attacks

Grief and Loss

Codependency

Substance Use - in Recovery

Immigration

Immigration Trauma

Therapy for Children

Mood Disorders