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)
Email
Phone
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:
Yes
No
Do you have a preference for type of appointment? (if no preference, please skip)
In-person
Telehealth
Tech support is available if you need help.
If you can use streaming services (Netflix, Zoom) on your computer or phone, you will have the internet bandwidth for a good telehealth connection.
If your internet connection struggles to stream smoothly, you’ll want to have in-person sessions.
I am a:
New client
Previous client or a family member has been a client
Are you seeking any of these specific services?
Substance Abuse treatment
Trauma treatment (includes depression and anxiety issues caused by trauma)
Anxiety/Depression Symptoms (no significant trauma)
Eating Disorder Treatment
Autism Spectrum Treatment
Art Therapy
OCD treatment
Behavior therapy for aggression issues
Behavior therapy for oppositional-defiant issues
Issues with self-harm (such as cutting)
Issues with suicidal thoughts
Reason for seeking therapy:
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.
How did you hear about us?