New Client Intake Form

Please complete the following form prior to your first appointment. Complete information is needed in order to build your profile in our system. Once received, our intake coordinator will contact you within 2 business days. If you don’t hear from us by then, please email us at admin@familytherapyllc.com.

Bethesda office:
5654 Shields Drive
Bethesda, MD 20817

Baltimore office:
30 East Padonia Road, Suite 202
Timonium, MD 21093

admin@familytherapyllc.com
(240) 883-6074

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