CONTACT.

Hey there, finding the right therapist can be hard and I am looking forward to speaking with you to ensure I am the right person for what you are needing.

After you submit the form, I will email you back within 48 hours (excluding weekends and holidays) with a link to schedule a consult.

If you need to cancel, please let me know. Thank you!

* IMPORTANT UPDATE: I will be on maternity leave from July to November 2025. We can discuss this during our call and determine the best plan for you during my leave. If you would like a list of referrals from colleagues instead, feel free to let me know in the form. Thanks!

Name

First Name

Last Name

Pronouns

Email

Phone

(###)

###

####

How did you hear about me?

How can I help?

I understand you are out of network.

Yes

I am a resident of California or Arizona.

Yes

I understand that you are only offering online sessions at this time.

Yes

I understand that you will be on maternity leave (July to November 2025). I understand that we can talk more about this at our call to plan accordingly.

Yes

By submitting this form via this web portal, you acknowledge and accept the risks of communicating your health information via this unencrypted email and electronic messaging and wish to continue despite those risks.

Please only share minimal information.

If you have any questions, email me at elisa@mindfullymindingme.com, talk with you soon!

CONTACT.

Thank you. I will e-mail you my openings for consults soon! (usually with in 1-2 business days).

Please check your email and your spam folder, my email is elisa@mindfullymindingme.com. If you do not hear from me with 48 hours (excluding weekends and holidays, call me and leave me a voicemail. Talk with you soon! Thanks!