Request an Appointment

Name

First Name

Last Name

Email Address

The email provided will be contacted in response to this inquiry

Phone Number

The phone number provided will be contacted in response to this inquiry

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Service Requesting

Please select the type of therapeutic service you are inquiring about

Therapist Requesting

Please be aware that therapist requesting may not be available, but a therapist suited for your needs will contact you.

Insurance or Self-Pay

Please note, not every therapist is paneled with all insurance companies listed below. We will do everything possible to connect you with an in-network therapist.

Are you seeking In-Person or Tele-Therapy?

Brief reason for seeking therapy (If for a child, please specify age)

Please note the age of your child, if child therapy inquiry

Please Note

Contact through this form is not HIPAA compliant. If you desire to make contact in a more confidential manner, please call the listed phone number.

Request an Appointment

Phone Email Fax

704-912-4095 info@davidsonfamilytherapy.com 704-943-0512

Addresses

709 Northeast Drive, Suite 22 Davidson, NC, 28036

20501 N Main Street Cornelius, NC 28031