I do my best to get to all emergencies quickly.  Please respect this process and only fill out this request if it is a true emergency.

Your First and Last Name:  

Date of your currently scheduled appointment with me: (if you do not schedule a session I will keep you on the emergency list for 5 days, then drop the request if I have not been able to fit you in - I try my best!)

Give as many phone numbers as possible so that I can find you.

Daytime Number:

Evening Number:  

Mobile Number:

E-mail:

How early in the morning and late at night can I call? 
REMEMBER I am Eastern Time:  
                                                    Example: 7 AM - 10 PM EST

Payment:  I may call you with only 10-15 minutes to talk.  Payment will be due at the time of the call and the following rates will apply:
10-15 minutes will be $28
16-35 minutes will be $48

Brief Description of Emergency: