Please enter your information below. If you are inquiring about services for your child, please enter their name.

First Name

Last Name

Date of Birth (mm/dd/yyyy)   


Spencer Psychology uses a texting service to notify clients when an appointment is available. Please be sure to include your cell number as your permission for us to contact you through text, as your “opt-in”. We do not use your number for any other purpose than scheduling, and you may opt-out at any point by notifying us.

I will be using insurance as part of my payment:  
Do you have a preference for type of appointment? (if no preference, please skip)

I am a:   

Are you seeking treament for any of these specific symptoms, issues, or services?
In order to match you to a therapist, please tell us the reason you are seeking therapy, and what symptoms you are struggling with (i.e. depression, stress, anxiety, OCD, trauma, etc). The more detail you can give, the better we can match you.

Reason for seeking therapy:   
If you are currently seeing a therapist, please describe in the box above. This will help us in matching one of our therapists with you.

How did you hear about us?