Individual Intake Request Form

Thank you for interest in individual therapy with ITTC, please fill out and submit the form below to add yourself to our inquiry list. Wait times are highly unpredictable and dependent on a number of factors that are out of our control. Under some circumstances, there is no wait… in others, up to twelve weeks. In general, the more flexibility you can offer, the sooner we can find space for you.

It is helpful if you have read our team bio’s prior to completing this form.

As a reminder: All our therapists are versed in trauma, but each one also has a specific area of expertise. You can be as vague or as specific as you feel comfortable with.

All questions with a * need to be completed.

This form is powered by Hush™ Secure Forms, ensuring compliance with HIPAA regulations. If you require any specific assistance while completing this form, please feel free to contact us at (971) 266-6910, and we will be happy to assist you.

ITTC is no longer accepting new clients for medication management.