Name *

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First Name

Last Name

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Phone

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WHAT CSAM DOES NOT TREAT: Please note that while anxiety disorders can co-occur with other concerns, at CSAM we specifically focus on treatment of anxiety disorders. We do not treat clients with a primary diagnosis of depression or those having serious suicidal ideation, self-harm (e.g. cutting, burning, scratching, or similar), substance abuse or dependence, bipolar disorder, or borderline personality disorder (BPD). For BPD, or similar conditions involving significant emotion dysregulation, Dialectical Behavioral Therapy (DBT) is a superior treatment option. *

I have read and understand what CSAM does NOT treat.

Informational Call Availability

Please select your general availability for our Client Coordinator to call you and discuss therapy goals.

Mon-Fri 8 am-11 am

Mon-Fri 11am-2 pm

Mon-Fri 2-5 pm

Other (Include details in the "message" portion of this form).