Complete the form below

I will reach out via email to schedule our session

You’ll receive a confirmation email, link to our video session, and intake documents if you select an intake appointment

We’ll begin our work together and you’ll be one step closer to your goals!

Scheduling Form

Name

First Name

Last Name

Partner's name

First Name

Last Name

Reason(s) for seeking therapy

Scheduling preferences

I will do my best to accommodate any scheduling requests. I see clients M-Th 10am-7pm.

Appointment Preference

Are you interested in a free 15-minute consultation or would you prefer to schedule your intake appointment?

A free consultation, please!

I'm ready to jump in - let's schedule the intake!

Please check below

I confirm that I reside in Minnesota and will be in Minnesota for all therapy sessions

I understand that all consultation and therapy sessions with Clover Counseling will be conducted via telehealth