Let's get in touch.dustin.hiles@fitpsychotherapy.com(970) 614-87651905 15th St. #2091, Boulder, CO 80306 Name * First Name Last Name Email * Date of Birth * Gender Pronouns Telephone Number * Preferred Mode of Contact * Can I Call You? Can I Leave You A Voicemail? Can I Email You? How Do You Want To Pay For Therapy? * Private Pay (Full Fee) Reduced Rate (Sliding Fee) Medicaid (No Co-Pay) What Brings You To Counseling At This Time? How Did You Hear About My Practice? * Is There Anything Else You Would Like To Add, Or For Me To Know Specifically—At This Point? Thank you!
