Courtney Ellis | SimplePractice

Courtney Ellis Send Message

Who would be receiving care?

Me

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Reason for care

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What is your preferred way to meet for sessions?

In-Person Telehealth Both Not sure

Client Preferences

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Do you have any specific preferences for meeting times?

Morning Afternoon Evening Monday Tuesday Wednesday Thursday Friday I'm flexible!

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Return Response

Do you give permission for Courtney to respond to your inquiry via email, which is not a guaranteed secure means of communication?

Yes No Phone Call Preferred

For medical emergencies, contact your healthcare provider or call 911. For mental health crises, call or text 988.

By submitting this form, you agree to the processing of your sensitive personal information, which may include protected health information (PHI). This information may be viewed by team members in this practice. You also agree not to submit any payment information, including credit or debit card details, through this form.