Connect Now
Whether you are ready to take the next steps or seeking clarification, use our contact form to get connected with us.
Filling out this form is not a commitment, it only begins the conversation. You can expect us to reach out to you within 24 - 48 hours of submission of this form. If you prefer, feel free to email, call, or directly schedule with us below.
We look forward to connecting with you soon!
hello@activvcounseling.com
(703) 966-5173
Let's get started.
Please provide some basic information so our team can learn a little about you and help connect you with the right provider.
What kind of service are you interested in?
Select all that apply.
How would you prefer to meet?
Select all that apply.
Do you have a preferred location?
This is optional. If you don't have a preference, we'll simply use your selected locations when matching you with a provider.
Do you have a therapist preference?
If you don't have a preference, that's completely okay.
Do you plan to use insurance?
If you'd like us to verify your eligibility before your first appointment, please email the front and back of your insurance card to:
YOUR-ELIGIBILITY-EMAIL@EXAMPLE.COM
Please include your full name and date of birth in the email.
What does your typical availability look like?
Select the times when you are generally available for appointments. You can select multiple times.
How flexible is your availability?
What brings you here?
Tell us a little about what you're looking for or what you'd like support with. Share as much or as little as you're comfortable with.
Thank you.
We've received your request. Our team will review your information and contact you regarding next steps.