If you are ready to schedule an intake appointment with one of the providers at The LEAP Clinic or if you have any questions about how The LEAP Clinic can support your family, please fill out the contact information below. After you fill out this form, we will contact you within 24-48 hours to get your intake scheduled! 

 

Please do not share any personal health information in this form, as this information should be provided during the consultation call.  While The LEAP Clinic will always prioritize confidentiality, the use of email is inherently insecure and thus poses a risk to the security and confidentiality of protected health information. By filling out this form, you consent to The LEAP Clinic communicating with you by non-secure email at the address provided. This may include Protected Health Information (PHI) related to the scheduling of therapy sessions and/or other appointments.