Chris Lanterman Therapy — Online Couples Counseling Booking

new client inquiry

I’m happy to provide a free 20-minute virtual consultation to determine if I’m the best fit for your goals.

Name

First Name

Last Name

Pronouns

Phone

(###)

###

####

Email

How did you hear about me?

Please be specific (name of referral or website)

What State do you reside in?

I can provide therapy to KS & MO residents.

Kansas

Missouri

Neither

Please indicate the type of support being requested.

Couple and/or Relationship Counseling

Individual Counseling

Please indicate the topics you want to process in therapy.

Please indicate your goals for counseling.