Curious about working together? First Step: Completing this form I’ll reply to your email within two business days. Alternatively, feel free to leave me a phone message: 207-560-3915 Name Email Address Phone What are you seeking support for? (Check all that apply) What are you seeking support for? (Check all that apply) Chronic dieting/weight cycling Body image Intuitive Eating Binge Eating Eating disorder/disordered eating Preoccupation with food Chronic health condition Family mealtime struggles Other (add comments below) State of residence Payment options Payment options I plan to use insurance I plan to pay out-of-pocket and would like to receive a Good Faith Estimate Medical Insurance Medical Insurance Aetna Anthem Cigna Community Health Options Harvard Pilgrim United Healthcare Other Insurance No Insurance Appointment Type Appointment Type I prefer virtual sessions I prefer in-office sessions I do not have a preference You may leave additional comments here, including a bit about why you're reaching out. 13 + 10 = Submit