Request an appointment

Please include as much detail as possible.

Questions? Call our Administrative Team at (414) 771-9304 Monday-Thursday, 10am-5pm and Fridays from 11am - 3pm.

Name

First Name

Last Name

Phone

(###)

###

####

Preferred Method of Contact

Insurance Company

Age Range

Message

Sharing as much or as little as you are comfortable with about what brings you to counseling helps us to connect you with the right clinician. All messages are confidential and HIPAA-compliant.

Availability

Please include details about your typical availability for appointments.

Location

Therapist Preference

We do our best to honor therapist requests.

Request an appointment

SHORE CLINIC

info@shoreclinic.com