Appointment Form Ready to take the next step?Name(Required) First Last Email(Required) Phone(Required)Location(Required)Indiana (In-Person or Virtual)New Jersey (Virtual Only)Delaware (Virtual Only)Florida (Virtual Only)California (Virtual Only)Therapy Service(Required)Individual TherapyCouples TherapyMindfulness GroupNot SureAdditional Information(Required)Information provided on this form may be accessible beyond Living Mindfully LLC. We encourage you to share only the details necessary to request an appointment to ensure your privacy and confidentiality. If you are experiencing a mental health crisis please call 988 to reach the National Suicide Prevention Lifeline. Another option is to call 911 or go to your nearest emergency room. CAPTCHA
