Let’s connect!

Please note I currently do not have openings for new clients and do not anticipate having openings until winter 2025 at the earliest. - July 2025

If you’re looking for therapy with Mercuri Rose, you can complete the form below to let them know. You’ll notice most of the responses are not required, skip anything you’re not comfortable disclose through this online form. Alternatively, you can contact me directly via email at therapy@mercurirose.com

My response may take a few days. I appreciate your patience.

Affirmed Name

Legal Name

Pronouns

Phone (text only)

(###)

###

####

What brings you to therapy at this time?

Only a brief summary is needed

Insurance

What days or times are you available for appointments?

Telehealth or in-person?

How did you hear about Mercuri?

e.g. psychology today; a friend; another therapist; etc.

Comments or Questions

I agree to First Planet Therapy Terms of Use & Privacy Policy (linked in footer)