SEEKING A THERAPIST

If you’re seeking a virtual therapist you’ve come to the right place. Simply complete the form below and we will be in contact within two hours to connect you with therapist options based on your preferences.

Name

First Name

Last Name

This is where eTherapyCare corporate communications will go. You will be provided an @etherapycare email address as well.

Phone

(###)

###

####

Home Address

For Corporate Info only, only state will be shared publicly.

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Your Availability

What are your preferred days and times to meet on a recurring basis?

Therapist Gender

Male

Female

No Preference

Tell us more...