Request a Consultation Please answer the following questions and Dr. Chanelle Richards, Ph.D. will be in touch to schedule a brief phone consultation to learn more about your needs. FIRST NAME LAST NAME WHAT BRINGS YOU TO THERAPY? Your information will be sent directly to Dr. Chanelle Richards, Ph.D. If this is an emergency, please do not use this form call 911. EMAIL ADDRESS PHONE NUMBER BEST TIMES TO REACH YOU HOW WOULD YOU LIKE TO BE CONTACTED EMAIL CALL TEXT By entering your information you are providing consent to be contacted by Dr. Chanelle Richards, Ph.D. via email, phone, voicemail or text. Please be aware that email is not a secure means of communication. Summit Request
