Alyssa Koelemay, LSWAIC
Services
Individual Counseling
Therapy for College Students
Therapy for Anxiety
Trauma Therapy
About
Connect
Continue your mental health journey here.
Please enable JavaScript in your browser to complete this form.
Please enable JavaScript in your browser to complete this form.
Name
*
Name I help?
Phone number
*
Email
*
I want to…
*
Schedule an new client appointment
Schedule a complimentary 20-minute consultation
Something else
How can I help?
*
How did you hear about my practice?
*
— Select Choice —
Psychology Today
The Embody Lab
Mindful Therapy Group
Friend
Referral from another provider
Insurance provider
Internet search
AI chatbot (e.g., Chat GPT)
Other
Privacy Acknowledgement
*
I understand that this form does not meet HIPAA privacy standards and therefore should not contain any personal healthcare information. I agree to this information being used by Alyssa Koelemay, LSWAIC to contact me by email or text message for the sole purpose of establishing further HIPAA-compliant communication as it relates to future healthcare.
Submit