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Contact Form

To contact Ms. Julie directly for her services or if you have any questions or concerns, please fill out the form below and she will get back you you as soon as she can.  If this is an emergency, please call 911. Other emergency numbers include the Crisis hotline at 1-888-767-4493, the Suicide Prevention Hotline at 988, or your local emergency room for assistance. 

Child/Client Information

If you are looking to get treatment for more than one child at a time, please include all information for all potenntial clients below

Parent Information:

If applicable, please include information for both the primary and secondary parent/guardian in the fields below

Insurance Information

* If using insurance, please email images (front and back) of insurance card, including the name of the potential client, to info@distinctivecounceling.com 

Thanks! Message sent.

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