Please print and complete the forms to allow us to spend an entire session with you for your initial consultation.
Complete the Individual Intake Form and all required consent documents.
Each partner must complete the couples Intake Form and sign consent documents. Please complete forms separately.
If you are experiencing a behavioral health emergency, please call 911 or go to your nearest emergency room.
To request an appointment, please send an email to jumana@southcharlottetherapy.com or call 704-277-7157.
8832 Blakeney Professional Drive Suite 103 Charlotte, NC 28277
Across from Elevation Church in the Blakeney Professional Park. 8832 Blakeney Professional Dr. Charlotte, NC 28277
