Foundations of Love Course Preview Opt-In - The Couples Center

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Foundations of Love Course Preview Opt-InMiranda Cameron2025-02-12T06:11:24-08:00

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Complete Our Intake Form to Match the Right Relationship Therapist

First Name *

Last Name *

I identify as: *

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Phone Number *

Email Address *

Preferred Contact Method *

Partner's First Name *

Partner Identifies as: *

Partner's Birth Year *

Preferred location of sessions. *

What's the best time for a follow up consultation call? *

Best Day(s) and Time(s) For Sessions (may select more than one) *

Weekday Mornings (Before 12 Noon PDT)

Weekday Early Afternoon (12 pm - 4 pm PDT)

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Please Note Specific Times That Work For Sessions *

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Our licensed therapists have 5+ years of experience. Our associate therapists have 2-5 years of experience and work on a sliding scale. Note: select only one option. Please see our fees below for more information. *

Senior Therapist ($250 per 50 min session, $370 per 75 min)

Licensed Therapist ($220 per 50 min session, $325 per 75 min)

Associate Therapist ($160 per 50 minute session, $235 per 75 min)

Either is fine, I want the therapist that is the best fit for me.

Please select the applicable reasons you are seeking therapy: *

Learn Communication Skills

Sex/Intimacy Counseling

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Premarital Counseling

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We're good, but we want to be great.

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If comfortable, please describe how/when the fights escalated:

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Avi Anderson – Care Coordinator at The Couples Center.

Start Therapy in the Month of June & Get 50% off Your First Session.

When you fill out our intake form or call me – Avi – the care coordinator at 415-322-0417, I will help you get started today and match with a therapist. Offer is good for the first couples therapy session booked by June 30th, 2025. Each session after will be regular priced.

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Complete Our Intake Form To Match With The Right Relationship Therapist

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