Wondering If We Might Be A Good Fit?
Complete this application if you wish to schedule a phone call. The purpose of the interview is for me to gather clinical information and recommend whether or not you should schedule an initial consultation. It is not to provide basic general information about my services.
Please complete this form only if:
1) You have already thoroughly reviewed my website
2) You have gotten all your financial questions answered by the information I've provided on https://michaelgquirke.com/my-practice/
3) You don't have general questions. You have one very specific clinical concern. This one question makes you wonder whether or not you should schedule your initial consultation via my online scheduler.
If so, just fill out this pre-screening client interest form. We can then schedule a 15 minute no charge consultation.
If you need immediate assistance, please call 911