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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:

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  • This is not a mental health emergency or urgent matter

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  • 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.

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

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  • 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.

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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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