Contact Me

Get in touch!

Please fill out the intake form below. I will typically respond within 48 hours to let you know when our consultation call will be. The consultation is an opportunity for me to get a better idea of what it is you want to work on, so we can work together on determining the best course of action for you. It is also an opportunity for you to ask questions. You may also list your questions in the form below and I will answer them when we speak. If you don’t see a response from me please check your spam folder.

If privacy is a concern, set up a Protonmail email address, which is what I have. There is end to end encryption if we both use Protonmail. Please note that this form is not encrypted. If you’d like you can copy and paste the form into an email and send it over to EileenChao (at) protonmail (dot) ch.

Covid Information: I am fully vaccinated and will still be getting covid tested once a week. To see me I will either require you to be fully vaccinated or present a negative covid test prior to every appointment. Mask wearing will still be required in order to keep everyone safe.

Your Name(s):

Age(s):

Your Email:

Your Phone:

Location (city, state, country):

3 dates and times you are available for a 10-20 minute phone consultation. Please provide specific dates as well as time range of availability for each date (ex: 1/15 12pm-3pm):

Are you currently in a relationship?

Are you currently in therapy?

Have you ever been in therapy?

What are you seeking?

Provide a short description of the challenge or issue you are seeking help for:

How long has this been an issue for you?

How did you hear about me?

Type questions you have for me here. If you don't have any at this time type "none".

All fields are required.