Contact UsEmail: hello@thatgaytherapist.comPhone: (909) 493-6096 (Texting preferred) Name * First Name Last Name Gender identity and pronouns Are you over 18 years old? * Phone (###) ### #### Email * What is your main concern that you would like help with? * Check off what currently applies to you Depression Anxiety Trouble controlling worry Suicidal thinking Self-harm Religious issues Deconversion Trauma EMDR therapy Identity issues Sexual orientation issues Gender Identity/ expression issues Low self-esteem ADHD symptoms PTSD Communication issues Which state are you located? * What insurance do you have? Thank you!
