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Get Help Now
Please complete this form and we will call or send you an email within 24 hours to match you with the right therapist for you.
Your therapist or coach preferences:
Please make your selections below so we can make the best possible therapist match:
Our fee per 50 minute session varies based on life experience, clinical experience, training, education (master's, doctorate), and special certifications. Please indicate the fee you are able to pay and we will do our best to match you with the appropriate professioal.
Where do you reside? (this impacts whether you are matched with a neurodiverse therapist or a neurodiverse coach).

Information shared on this intake form may be viewed by members of the Affair Recovery Therapy Center staff in order to match you with the therapist who is the best fit for you. 

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