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Ready to contact us and schedule your appointment?

We make the process simple!

If you are ready to talk to us about scheduling your free 20 minute phone consultation or to request an appointment, there are three ways to get in touch with us at Relationships Matter Austin.

1) You Can Schedule Your Free 20 Minute Phone Consultation or Request An Appointment Online- 

2) You can call us at 512-994-0432. If no one is available to take your call, please leave a message and your call will be returned as soon as possible, and always within 24 hours.


3) You may also complete the form below and we will contact you within 24 hours.

It’s that easy. Contact us now!

First and Last Name (required)

Your Email (required)

May we contact you by email? (required)

Phone Number (required)

May we leave a message for you at this phone number? (required)

What type of counseling service are you requesting? (required)

Couples CounselingIntensive Couples CounselingPremarital CounselingIndividual CounselingIntensive Individual CounselingParent Counseling CounselingTeen CounselingFamily CounselingEMDR TherapySomatic Experiencing TherapySand Tray TherapyWorkshopGroup

If registering for a workshop or group, please select it below:

Modern Moms GroupParenting Skills GroupGet It Girls GroupHold Me Tight® Workshop for CouplesBefore 'I Do' Preparing for Marriage GroupStrengthening Your Inner Champion With Self Compassion GroupModern Moms WorkshopParenting Skills WorkshopBefore 'I Do' Preparing for Marriage Workshop

Partner’s Name (optional- for couples counseling)

Partner’s Email (optional- for couples counseling)

Partner’s Phone Number (optional- for couples counseling)

Fee Requested
Please select the fee based on your ability to pay and what works for your personal budget and finances. No verification of income or proof of need for sliding scale services is required.

Insurance
Blue Cross Blue ShieldOther

(Note- The first session, also known as the intake session, is 80 minutes in length for all couple and family appointments. This allows us plenty of time to discuss your needs and goals. Fees for the 80 minute intake session are: Intern clinician- $100, Mid-level clinicians- $150, Senior level clinicians- $185)

Fee for our Intern Clinicians:
$80 per 50 minute session$90 per 50 minute session$100 per 50 minute session$110 per 50 minute session$135 per 80 minute session

Fee for our Mid-level Clinicians:
$120 per 50 minute session$130 per 50 minute session$140 per 50 minute session$150 per 50 minute session$195 per 80 minute session

Fee for our Senior level Clinicians:
$160 per 50 minute session$170 per 50 minute session$180 per 50 minute session$240 per 80 minute sessionGroup FeeWorkshop Fee

I need the following appointment schedule:

Evening AppointmentWeekday AppointmentWeekend Appointment on SaturdayWeekend Appointment on Sunday

If you need your appointment scheduled for a specific weekday, weekday evening, or time of the day on the weekend, please indicate your preference below.

I prefer to attend appointments:
Online (through secure client portal)In Person

I want to address the following issues in counseling:

Communication ConcernsConflict in RelationshipDivorce/End of RelationshipDepressionAnxietyManaging Overwhelming EmotionsTraumaAddiction/RecoverySelf-EsteemPersonal EmpowermentFinding Work-Life BalanceYoung Adults / Young Couples in 20s and 30sAdults / Couples 50+Premarital CounselingPrepare / Enrich Premarital CounselingFamily Relationship(s) / Family of Origin IssuesPerformance Concerns for AthletesInfidelity in RelationshipLGBTQ Relationship ConcernsSexual HealthSexual ConcernsMulti-cultural / Intercultural IssuesCareer or Work ConcernsGrief & LossFamily of Origin IssuesTeen CounselingExpecting/ New ParentsAdoptionParenting SupportParenting Teens with Behavioral TroublesStep parenting and Blended FamiliesDifficult ChildhoodFinancial ConcernsOther

How did you hear about us? (Website, referral, etc.) (required)

Is there other information you would like to provide?

Notice regarding email communication
This form will be submitted to Relationships Matter Austin via email message. Email is a convenient form of communication, but confidentiality of the information submitted cannot be guaranteed due to email providers storing information on their servers. It is possible that your form submission could be viewed by a third party. By submitting this form, you are acknowledging the risk, however unlikely, that may be involved in submitting this form.

I have read the statement above regarding submission of this form and acknowledge and agree to its contents.

 

If you are experiencing an emergency, please call 911 or: 

ATX 24-HR Crisis Hotline:
(512) 472-4357
Shoal Creek Psychiatric Hospital:
(512) 452-0361
St. David’s Pavilion Psychiatric Hospital:
(512) 867-5800
National Domestic Violence Hotline:
1 (800) 799-7233
ATX 24-HR SAFEline (abuse/domestic violence):
(512) 267-7233
National Suicide Prevention Hotline: 
1 (800) 273-8255
LGBT Trevor Project Lifeline:
1 (866) 488-7386
National Sexual Assault Hotline:
1 (800) 656-4673
Crisis Text Line:
Text “HOME” to 741741