Let’s work together

A woman wearing a red headscarf and white shirt, sitting on a gray couch with an orange cushion, writing in a notebook, in a room with framed artwork and a large plant in the background.

Interested in working together? Fill out the contact form, and I will be in touch shortly.

Name

First Name

Last Name

Email

Phone Number

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I am over the age of 18.

Yes

No

By checking this box you consent to receiving contact via email and phone from Quiet Magic Therapy.

I agree

What service(s) are you interested in?

Individual Therapy

Clinical Supervision

Professional Consultation

Career Mentorship

Speaking Engagement

How did you hear about me?

How can I help?

Please do not include sensitive or confidential information as this form is not a secure method of communication.

Disclaimer: This contact form collects your name, email, phone number, and age; this information is categorized as “protected health information” under HIPAA. By submitting this form, you acknowledge that this information will be sent through electronic submission and may carry risk of unauthorized access. You also accept this risk and agree to hold Quiet Magic Therapy, PLLC harmless in the event of unauthorized access or disclosure.