Contact us.

fightress@nbcounselingllc.com

334-293-1411 (call or text)

I am currently licensed to support clients in the state of Alabama and Florida. If you do not currently live in the state of Alabama or Florida, please visit https://www.psychologytoday.com/ to locate a provider in your area.

Name

First Name

Last Name

Phone

(###)

###

####

In a few sentences, tell me what brings you to therapy? What are the main areas that you could use some support in right now?

Who May I Thank for Referring You? (Psychology Today, Friend, TFBG, Google, etc)

What about my website/profile led you to reach out to me specifically?

My current availability for appointments are as follows: Weds/Thurs/Sat/Sunday between 10 AM-8: 00 PM CST. Please list all possible times that you could make an appointment.*

Are you ready to begin therapy sessions within the next 1-2 weeks?

Yes, I am ready.

No, I am not ready.

State Verification

Please check the box below to confirm that you live in the state of Alabama or Florida.

I live in Alabama or Florida.

I do not live in Alabama or Florida. (Please visit Psychology Today to find a provider in your area. I am only licensed to support clients in Alabama).

Insurance Info

If you would like to use your insurance benefits to cover the cost of therapy sessions, please list your Insurance provider, Member ID, and DOB below so that your benefits may be confirmed. You will receive an email notification regarding copays and deductibles. If you are not wanting to use insurance benefits, type 'Private Pay'.