• 5330 E Main St.,
    Suite 100B,
    Whitehall, OH 43213

Forms

If you're a new client, please complete the following forms and bring them to your first therapy session.

If you would like me to coordinate care with another provider (for example, your psychiatrist, primary care physician, etc.), complete this form to authorize release of psychotherapy information:

Note: To download Adobe Acrobat Reader for free, Click here.

CONTACT US

We hope to see you soon

  • Rainbow of Resilience LLC

    5330 E Main St.,
    Suite 100B,
    Whitehall, OH 43213 US

    Monday:

    9:30 am - 5:00 pm

    Tuesday:

    9:30 am - 5:00 pm

    Wednesday:

    9:30 am - 5:00 pm

    Thursday:

    9:30 am - 5:00 pm

    Friday:

    9:30 am - 5:00 pm

    Saturday:

    Hours available upon request

    Sunday:

    Hours available upon request

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Please do not submit any Protected Health Information (PHI).