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Interest Form

Thank you for your interest in Endeavor Counseling. Please fill out the following form and I will reach out to you to schedule your free 20 minute consultation.  

By submitting this form, you acknowledge the following:

  • This is not a mental health emergency or urgent matter

  • The purpose of the free 20 minute consultation is to learn about Endeavor Counseling. It does not establish a therapist-client relationship and is not meant to treat or diagnose mental health concerns.

  • Due to telehealth licensing requirements, Endeavor Counseling can only work with residents of North Carolina. 

  • All counseling sessions are provided via secure video chat. I have reliable access to a computer with high speed internet.

Endeavor Counseling is considered an "out of network" provider. You are responsible for paying the future fee of $165 per session, or an agreed upon reduced fee. If you wish, I will provide you a statement you can submit to your insurance for partial reimbursement, but cannot guarantee you will be reimbursed.


By submitting this form, you consent to Endeavor Counseling contacting you via email or phone. You further agree to our website privacy policy & terms of use.

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