Name *

First Name

Last Name

Do you prefer that we contact you by email or phone? *

Phone

Email

Both are okay

Are you comfortable with us leaving a message identifying ourselves as Haven Mental Health Counseling at the phone number you provided? *

Yes

No

If you're seeking treatment, please select your preference below

Online Therapy

In person (New Hyde Park)

Please note that we are an out of network provider, which means that we do not take insurance. Have you reviewed our policies & rates page for answers to questions on insurance and other related issues. *

Yes